{LIBRARY OF CONGRESS. 

#|H J tywtyt J|». 



! UNITED STATES OP AMERICA. 



V 



THE 

MOTHER'S 



Hygienic Hand-book; 



FOR THE 

NORMAL DEVELOPMENT AND TRAINING 
OF WOMEN AND CHILDREN, 

AND THE 

TREATMENT OF THEIR DISEASES WITH 
HYGIENIC AGENCIES. 



BY 

R. T. TRALL, M.D., 

author of 

" Hydropathic Encyclopedia," 

"The True Healing Art," "Hygienic Hand-book," 

" Uterine Diseases and Displacements," 

" Sexual Physiology," " Sexual Pathology," " Diphtheria," 

"The Alcoholic Controversy," 

"The True Temperance Platform," "Water-cure for the 

Million," "The Hygienic System," "Digestion 

and Dyspepsia," etc. 









NEW YORK : 

S. R. WELLS, PUBLISHER, 389 BROADWAY. 

1874. 



Entered according to Act of Congress, in the year 1874, 

By S. R. WELLS, 

In the Office of the librarian of Congress at Washington. 



CONTENTS. 



PAGE 

PREFACE 3 

INTRODUCTION 5 

CHAPTER I. 
Ante-Natal Influences n 

CHAPTER II. 
Anatomy of the Uterine System 21 

CHAPTER III. 
Displacements of the Uterus 25 

CHAPTER IV. 
Menstruation 28 

CHAPTER V. 
Menstrual Disorders 34 

CHAPTER VI. 
Pregnancy 43 

CHAPTER VII. 
Miscarriage 55 

CHAPTER VIII. 
Presentations and Positions 60 

CHAPTER IX. 
The Foztus in Utero 64 

CHAPTER X. 
Parturition « 69 



ii Contents. 

CHAPTER XL PAGE 
Diseases during Pregnancy yy 

CHAPTER XII. 
Management of Labor 88 



CHAPTER XIII. 
Attentions to the Child 98 

CHAPTER XIV. 
Attentions to the Mother 102 

CHAPTER XV. 
Disorders Incident to Labor 105 

CHAPTER XVI. 
Disorders during Lactation m 

CHAPTER XVII. 
Disorders of Infancy 119 

CHAPTER XVIII. 
Disorders of Childhood 129 

CHAPTER XIX. 
Training of Children 144 

CHAPTER XX. 
Hygiene of Infancy 1 53 

CHAPTER XXL 
Raising Children by Hand 170 

CHAPTER XXII. 
Accidents and Emergencies \ 173 

CHAPTER XXIIL 
Poisons and Antidotes 183 



PREFACE. 



It is natural for women to desire children. Every married 
woman, whose social relations and individual conditions are 
not abnormal, does desire them. But the artificial habits 
of society have so deteriorated the health of the majority of 
the women of all civilized countries that the idea of maternity 
is associated with many diseases and perils. The function of 
child-bearing is regarded almost everywhere in civilized society 
as necessarily attended with more or less of sickness, much 
suffering, and, possibly, death. And the impression is also 
very general among women that raising children is devitalizing 
and conducive to premature decrepitude and infirmity. It is 
for these reasons, more than because of pride, selfishness, or 
depravity, that so many women seek preventives of pregnancy, 
resort to abortion, or practice feticide or infanticide. 

During a practice of more than thirty years I have noticed 
that the sufferings of child-birth, and the diseases incident to 
the periods of gestation and nursing, are, invariably, other 
circumstances being equal, in the direct ratio to the unhygienic 
habits of the mothers. Some women do, indeed, enjoy such 
favorable organizations and vigorous constitutions that they 
suffer little, comparatively, notwithstanding their habits of 
eating, drinking, dressing, exercise, &c, are in violation of 
almost every law of organic life ; while others, of feebler 
vitality and less fortunate development, may suffer much, 



4 Preface. 

despite the most careful attention to hygiene. Such cases, 
however, are rare and exceptional. 

For more than twenty years, during which time I have had 
the professional care of one or more Health Institutions, I 
have been in the habit of receiving and treating women during 
confinement. Some of these were first cases ; others had suf- 
fered greatly in one or more previous labors \ but in no case 
did any one of my patients suffer severely. In most cases, 
although the labors were energetic, the pains were very slight 
and in all cases the sufferings were extremely trivial as com- 
pared with those of women generally. And when I add that 
the same results have attended all whom I have advised and 
attended in private practice, the reader may be prepared to 
appreciate the motives which have induced me to write this 

book. 

R. T. T. 

Florence Heights, N. J. 



INTRODUCTION. 



Motherhood ! There is no word, except God, of greater 
significance in human language. The function of maternity 
approximates creative power more nearly than any other known 
to human beings. The development of the primordial germ, 
the inception of life, the comminglement of the sperm and the 
germ cells producing an individual being, and the differentia- 
tion of cells into vessels, fibres, tissues, structures, and organs, 
ever have been and still are among the marvelous works which 
scientific minds admire and cannot solve. We know many of 
the processes or changes which organized matter undergoes in 
development and growth ; we understand many of the con- 
ditions which influence development and growth, and we are 
acquainted with a multitude of facts which relate to the never- 
ceasing transformations of a living organism, from the moment 
of conception to its final dissolution. But the mystery of life 
still remains unfathomed. Perhaps it will never be revealed 
until " this mortal puts on immortality." 

But for all practical purposes, so far as philosophy can com- 
prehend, it is enough for us to know the laws of our being, the 
circumstances which affect us beneficially or injuriously, and 
to understand the great fundamental truth underlying all 
human conduct, — that all good is found in obedience to the 
laws of organic life, and that all evil results from disobedience. 

Motherhood should be normal. But it never will be and 
never can be under the prevailing fashions of society. A man 
might as well drink intoxicating liquor and then endeavor 

" To walk erect with face upturned to Heaven/' 
without gibbering or staggering, as a woman expect to eat, 



6 Introduction. 

drink, dress, and dissipate in the fashionable ways, and be 
the mother of healthy offspring. 

One of the pernicious errors abroad is that woman is the 
" weaker vessel " physically * thus accounting for, if not excus- 
ing, her manifold infirmities. Fashion is justified and nature 
blamed. This doctrine has its origin in viewing "woman as 
she is," and not " woman as she should be." The fact that 
woman in civilized life is, as a rule, feebler than man, is taken 
as the evidence of constitutional and natural infirmity. 

There is no truth in this notion. Physically woman is man's 
equal. In bodily stamina, powers of endurance, vital resources 
and muscular strength, under the same circumstances of habit 
and education, she is in no sense his inferior ; on the contrary, 
if there is a difference, it is in her favor. This should be so ; 
and there is an anatomical and a physiological reason why it is 
so. The woman has not only to nourish herself but others. 
She must construct and replenish her own structures and those 
of the offspring. Hence she has the greater nutritive appa- 
ratus. It is because of this larger endowment of the nutritive 
system that her organization is more round and smooth, the 
organic nervous system more developed comparatively, and the 
glandular structures more prominent. 

That women can endure prolonged labor, privation of food 
and sleep, and unceasing care and watchfulness, better than 
men, has been noticed a thousand times by physicians in the 
sick chambers ; and, according to the opportunities, there are 
living to day quite as many aged and vigorous women, who 
have been active workers through life, as of men. I could 
name a hundred examples, but two or three of world-wide 
fame will illustrate the principle just as w r ell as a thousand 
could. 'Mrs. Sarah J. Hale, now eighty-four years of age, has 
labored incessantly in the field of literature for three score and 
ten years, and is now as busily and actively employed as in the 
days of her youth. Lucretia Mott, now eighty years of age, 
whose life has been one of remarkable industry and usefulness, 
retains all the powers of her vigorous mind seemingly unim- 



Introduction. 7 

paired, with extraordinary bodily power and activity. Mrs. 
Lydia Maria Child, after earnest and unresting labor for nearly 
half a century, during which time she has produced some of 
the ablest historical works ever written, — works requiring vast 
labor, the closest attention, and the most careful discrimination, 
with accurate analysis and profound reasoning, is still apparently 
in her prime, mentally and physically. And last, though not 
least, Mrs. Elizabeth Cady Stanton, who has raised a family of 
fine healthy children, is now, at the age of sixty, a model 
woman, so far as mental power and bodily organs are con- 
cerned. 

Perhaps no woman living is better qualified to give an 
opinion on the subject we are considering than Mrs. Stanton. 
In a recent lecture delivered in San Francisco, California, on 
the subject of "Marriage and Maternity," Mrs. Stanton said: 

" The idea that woman is weak, inherently, is a grand mistake. 
She is physically weak because she neglects her baths — because 
she violates every law of her nature and her God — because she 
dresses in a way that would kill a man. I feel it to be my 
mission to arouse ever} 7 woman to bring up her daughter 
without breaking her up in doing so. Our female idea of 
dress is all wrong. My girlhood was spent mostly in the open 
air. I early imbibed the idea that a girl was as good as a boy, 
and I carried it out. I would walk five miles before breakfast, 
or ride ten on horseback. After I was married I wore my 
clothing sensibly. The weight hung alone on my shoulders. 
I never compressed my body out of its natural shape. My 
first four children were born and I suffered little. I then 
made up my mind that it was totally unnecessary for me to 
suffer at all, so I dressed lightly, walked every day, lived as 
much as possible in the open air, ate no condiments or spices, 
kept quiet, listened to music, looked at pictures, read poetry. 
The night before the birth of the child I walked three miles. 
The child was born .without a pai'tide of pain. I bathed it and 
dressed it, and it weighed ten and a half pounds. The same 
clay I dined with the family. Everybody said I would surely 



8 Introduction. 

die, but I never had a relapse or a moment's inconvenience 
from it. 

" Another idea : It is of more importance what kind of a 
child we raise than how many. It is better to produce one 
lion than twelve donkeys. We have got donkeys enough ; let us 
go into the lion business. Suppose our great statesmen, Clay, 
Webster and others like them, had had only the society of 
refined and educated women, they would not have, as they did, 
looked upon women only in a physical light. If men have dolls 
for wives they will seek the society of intellectual courtesans. 
We must have a new type of womanhood. We need it more 
than gold. Courtesans ruled France and brought her to ruin. 
Courtesans will rule this country unless woman rises to 
her true dignity. The old idea of the oak and the vine is 
pretty, but it is mere poetry ; the emergencies of life prove its 
falsity — the lightning strikes them both alike." 

In concluding this introduction, the following remarks from 
another thinking woman, Rev. Antoinette Browne Blackwell, 
are worth recording : 

"Who are Healthy Women among us? 

" As I write from a rural neighborhood, I may be competent 
to testify that there still are healthy women among us — rosy- 
cheeked maidens, with ample waists and well -expanded chests, 
who can walk a mile or two to school, and sometimes help milk 
cows ; middle-aged, unmarried women, with stout, well-knit 
physique, plenty to do and cheerful hearts, accepting and glory- 
fying the most menial duties ■ mothers, who can bear the rea- 
sonable number of six or eight children, and look as whole- 
some still, in the green country setting as well-ripened apples 
in Autumn, hanging up among their glossy dark leaves. These 
are our healthy women. They all have something to do ; and 
yet are not overburdened either with care or never-ending 
labor. Now, who are the healthy women of the great world? 
When I used to be among them, "taking notes," I was im- 



Introduction. 9 

mensely impressed with the fact that it was invariably women 
who had something to do, and did it always with a vigorous and 
reasonable enjoyment in the occupation. In the field, in the 
factory, in the household, on the platform, in the study, in the 
studio, and in a hundred other places, I have seen such women ; 
but I never knew a thoroughly healthy woman who had nothing 
to do except to get other women to make her pretty little 
things to wear ; and to wear them herself, chiefly at midnight. 

" I am prepared to make the broad assertion that the average 
health of the intellectually working women of the last twenty 
years, in this country, is quite on a par with that of a smaller 
class of men. I affirm, moreover, that the health of mind- 
workers among men is rather below than above the medium 
standard of health for men generally — reason obvious : they 
stimulate mind at the expense of body. On the contrary, the 
average health of the women who coin money with their brains 
is above the average health of women generally — reason obvi- 
ous : they have gained an additional object in life ; have 
established a balance of harmony between mind and body 
— most of them still retaining a fair share of the ordinary 
duties and privileges of womanhood. It remains for the 
public to decide whether these assertions are correct or 
incorrect. If they are facts, here is one direct avenue to 
health for women already indicated. I believe, moreover, that 
the health of working women of all grades, throughout all 
the various occupations in which they are now engaged, is 
fairly equal — other things being exactly balanced — to the 
health of men in the same or similar vocations ! " 



CHAPTER I. 

Ante-natal Influences. 

Every child that is born is entitled to the inheritance of a 
sound bodily organization. This implies health on the part of 
both parents, but more especially on the part of the maternal 
parent, because she is much more immediately associated with 
the vital conditions of the offspring than the father is. 

The child is but the unfolding of the mingled germs. The 
fertilized ovum contains all the elements of the future being. 
These elements are unfolded, not created, in the processes we 
term development and growth. How* else can we account for 
the resemblance of children to parents ? This is the law of all 
vital organisms, otherwise there could be no transmission of 
organization, no continuous and distinct species of plants or 
animals. The stalwart oak is but the unfolding of the acorn. 
The plant has nothing that did not exist in the seed. Our 
farmers understand the importance of perfect seed in producing 
the best crops. And they are not ignorant of the fact that 
comely and profitable animals cannot be raised unless both 
parents are healthy when they are begotten. But how little 
these considerations are thought of, and how much less they are 
regarded, in relation to human beings ! 

All persons who expect to have children desire them to be 
beautiful and good. But the vast majority who do have children 
are wholly reckless of all conditions that ensure that result. 
They give being to immortal souls in diseased conditions of 
body and morbid states of mind, and then wonder that a 
" mysterious Providence " afflicts them with frail or depraved 
offspring. It would be a very mysterious Providence that 
would reverse the order of nature, stultify His own laws, and 
produce good consequences from bad causes. 



12 The Mothers Hygienic Hand-book. 

When we say that parents owe the duty to children of being 
healthy when they beget them, we have not quite reached the 
root of the matter. The woman who develops the germ must 
be healthy while she is doing it, or the germ will be defective, 
and its future unfoldment produce an imperfect being. There 
is, therefore, no practical solution of the great problem in 
sociology — normal organizations — except in training the 
girls healthfully. Who does not know that the great majority 
of girls, in all civilized countries, are reared, trained, educated, 
as well as fed and clothed, in direct opposition to all conditions 
of health, and all laws of their being? The wonder is not 
that so many are frail, but that any one is otherwise. 

" Ye cannot gather figs of thorns nor grapes from thistles." 
The child is fated, through its whole period of earthly existence, 
to endure or enjoy, as the case may be, the conditions which 
the good or bad qualities of its parents have forced upon it. 
That this subject is, more than ever before, attracting the 
attention of writers and lecturers, is a hopeful sign. The New 
York Tribune, not long since, asserted that the cause of half 
the vice among us is the ignorance of parents of the fact that 
certain nervous and cerebral diseases transmitted from them- 
selves tend to make criminals and drunkards of their children. 

A man may drink moderately but steadily all his life, with 
no apparent harm to himself, but his daughters become nervous 
wrecks, his sons epileptics, libertines or incurable drunkards, 
the hereditary tendency to crime having its pathology and 
unvaried laws, precisely as scrofula, consumption or any other 
purely physical disease. These are stale truths to medical 
men, but the majority of parents, even those of average 
intelligence, are either ignorant or wickedly regardless of them. 
There will be a chance of ridding our jails and almshouses of 
half their tenants when our people are taught to treat drunken- 
ness as a disease of the stomach and blood as well as of the 
soul, to meet it with common sense and a physician, as well as 
with threats of eternal damnation, and to remove gin-shops and 
gin-sellers for the same reason that they would stagnant ponds 



Ante-natal Influences. 13 

or unclean sewers. Another fatal mistake is in the training of 
children — the system of cramming, hot-house forcing of their 
brains, induced partly by the unhealthy, feverish ambition and 
struggle that mark every phase of our society, and partly for 
the short time allowed for education. The simplest physical 
laws that regulate the use and abuse of the brain are utterly 
disregarded by educated parents. To gratify a mother's silly 
vanity during a boy's school days, many a man is made incom- 
petent and useless. If the °boy show any sign of unnatural 
ambition and power, instead of regarding it as a symptom of 
an unhealthy condition of the blood-vessels or other cerebral 
disease, and treating it accordingly, it is accepted as an evidence 
of genius, and the inflamed brain is taxed to the uttermost, 
until it gives way exhausted. 

An eloquent writer says : " Women by nature are appointed to 
the holy mission of motherhood, and by this mission are 
directly charged with the care of the embryotic life, upon which 
so much of future good or ill depends. It is during this brief 
period that the initials of character are stamped upon the 
receptive incipient mentality which, expanding first into child- 
hood and on to manhood or womanhood, reveals the true secrets 
of its nature." 

The rights of children, then, as individuals, begin while yet 
they are in fcetal life. Children do not come into existence by 
any will or consent of their own. With their origin they have 
nothing to do, but in after life they become liable for action 
which perhaps was predetermined long prior to their assuming 
persona] responsibility. In youth, children are virtually the 
dependencies of their parents, subject to their government 
which may be either wise or mischievous, and is as often the 
latter as the former. But, having arrived at the proper age, 
they step into the world upon an equality with others previously 
there. At this time they are the result of the care which has 
been bestowed upon them from the time of conception, and 
whether they are delivered over to the world so as to be useful 
members of society, or whether they go into it to prove a 



14 The Mother s Hygienic Hand-book. 

constant annoyance and curse, seems to be a matter which 
cannot be made into such personal responsibility as to make it 
a subject of their own determining. At this period they find 
themselves possessed of a body and a partially developed mind, 
in the union of which, a harmonious disposition and character 
may have resulted. Respectively, they are possessed of all 
shades of disposition and character, from the angelic down to 
the most demoniacal ; but all these are held accountable to the 
same laws ; are expected to govern themselves by the same 
formula of associative justice, and are compelled by the power 
of public opinion to subscribe to the same general customs. 

All people are obliged to meet the world with the character- 
istics with which they have been clothed, and which they had 
no choice in selecting. When all things which go to make up 
society are analyzed and formulated, it comes out that society 
holds its individual members responsible for deeds of which it 
is itself indirectly the cause, and therefore responsible for. 

Another writer on this subject remarks : " It is scientifically 
true that the life which develops into the individual life never 
begins. That is to say, there is no time in which it can be 
said life begins where there was no life. The structural unit 
of nucleated protoplasm, which forms the centre around which 
aggregation proceeds, contains a pulsating life before it takes 
up this process. The character of the nerve stimula of which 
this is possessed, and which sustains this evidence of life, must 
depend upon the source from which it proceeds. In other 
words, and plainly, the condition of the parents at the time of 
the conception is a matter of prime importance, since the life 
principle with which the new organism is to begin its growth 
should be of the highest order. 

" Cases of partial and total idiocy have been traced to the 
beastly inebriation of the parents at and previous to con- 
ception. On the other extreme, some of the highest intellects 
and the most noble and loveable characters the world ever 
produced, owed their condition to the peculiarly happy circum- 
stances under which they began life, much of the after portion 



Ante-natal Influences. 15 

of the growing process having been under unfavorable 
circumstances. Many mothers can trace the irritable and 
nervously disagreeable condition of their children to their own 
condition at this time." 

The pernicious fashions of society which are demoralizing 
woman mentally and physically, as well as unfitting them to be 
mothers of anything but monstrosities, are forcibly stated but 
not exaggerated by Mrs. Henry Ward Beecher in the Christian 
Union of a late date ; under the heading of 

" What has become of all the Little Girls ? 

" We look in vain into many pleasant homes ; or into the 
streets, cars, or steamers, for what was once a common sight, — ■ 
and was then, and ever must be, the sweetest object in nature, 
— a simple, artless, little girl, with all the pretty, unaffected 
ways and manners of unsophisticated childhood, fresh and 
beautiful, about her. There is no lack of small beings, dressed 
in such a marvelous style that Darwin himself would be 
puzzled to make out the class to which they belong • but we 
find nothing to remind us of the little girls we used to know, 
either in dress or manners. 

" In former times a pretty muslin bonnet, or a 'simple close- 
fitting cottage straw, was thought the most appropriate covering 
for a little head — protecting the bright eyes from too intense light, 
and shielding the rosy cheeks from the sun's too fervid kisses. 
But now we see something, placed on the sunny curls — leaving 
eyes and cheeks entirely unprotected — which is elaborately 
trimmed with bows, feathers, a flower-garden, or perhaps a 
mingling of both • for, although it is too small for even a good- 
sized doll, the milliner, with an ingenuity which would have 
been praiseworthy if exercised in a more sensible manner, has 
contrived to pile up trimming enough to hide even the faintest 
suspicion of a bonnet. But, what is sadder than the lack of 
true taste and good common sense in this stylish affair, we see 
no semblance of child-like simplicity in the wearer. And the 



1 6 The Mothers Hygienic Hand-book. 

bonnet is but the beginning of this unfortunate change which 
we mourn. The pretty l baby waist] the plain white dress, the 
neat muslin or merino, so appropriate, which little girls used 
to wear, are supplanted by incomprehensible garments — the 
fac-simile of the grand dame's attire — flounces, fringes, bows, 
and double-skirts looped and festooned in an astounding man- 
ner, the child's — no, we mean the young lady's height, there are 
no children in these days — is less than her circumference. 
This dress is put on over a hoop, and the 'mite' who is made 
to carry such an incongruous burden, totters about on high- 
heeled boots. This tiny specimen of womanhood, hardly 
weaned from her mother's breast — or more probably, a wet- 
nuise's — shakes out her redundant robes, bending and twisting 
her small body in grotesque imitation of the woman spoken of 
by the prophet Isaiah, 'with haughty mien; walking and 
mincing as they go? See how the little ape looks over her shoul- 
ders, as she tottles about, to be sure that her hoops give her 
dress and figure the correct wiggle her sharp eyes have observed 
in the stylish mother and her fashionable friends. It is la- 
mentable that all the simplicity and beauty of babyhood and 
childhood should be destroyed by fashion. 

" Added to the absurdity of the dress, these little women at- 
tempt to discourse on the ' latest style.' With their companions or 
dolls you will hear them imitating the discussions on this 
subject, that they daily hear in the parlor or nursery, from their 
mother ; or, still imitating, with a contemptuous toss of their 
little heads, they will inform their listeners that they i couldn't 
think of 'sociating with those girls, because they are not stylish! ' 

"A few days since, as we passed out of a store on Broadway, 
our attention was arrested by the conversation of two little figures 
seated in a fine carriage, waiting, doubtless, for mamma to finish 
her shopping. They were dressed in a style positively over- 
whelming. Their hats were wonders of skill, their gloves had 
the orthodox number of buttons with bracelets over them, a 
dainty handkerchief suspended from a ring attached by a chain 
to another ring on the little doll-like fingers. The dress was 



Ante-natal Influences. 17 

simply indescribable. The elder was speaking to the younger, 
who, scarcely more than a baby, sat demurely by her side. 
■ Oh, mercy ! just look at that horrid little girl who is crossing 
the street ! She has no hoops on, and not a single flounce — 
no trimming at all on her dress ! And, oh ! see her gloves ! — 
why, she has only one button ! Pshaw ! she's nobody — not a 
bit of style ! ' 

" The youngest lisped a reply, which we lost as we passed 
on ; but it was painful to think of the training they must have 
received which enabled them at that early age to judge a child 
of their own years so quickly by the rules of fashionable dress, 
and because her attire was not in exact accordance with that 
week's style, turn from her with contempt as something too 
low for their notice. 

" Then, again, how soon a child taught by daily precept and 
example, learns to watch her little companions with envious or 
exultant feeling, as the case may be. How quickly she begins 
to grow hollow-hearted and deceitful ; receiving, as she sees 
her elders do, a companion with open arms, or a welcoming 
smile ; expressing the greatest affection, but the moment she 
leaves begin to criticise or make unkind remarks. 

" i I don't like Nelly one bit, mamma ; she's such a proud, 
stuck-up thing ! I suppose she thought I should feel Bad 'cause 
her dress had more trimming and was a little newer style than 
mine. I didn't let her know that I noticed it. But I do think 
it real mean, mamma, that she should have nicer things than 
mine. Papa is twice as rich as her father. It made me mad 
to see her show off her dress ; and she kept looking at mine 
and sister's in such a way.' 

" ' I hope, my dear, you were polite to Nellie.' 

" ' Oh, yes ! But, mamma, I was awful glad when she left — 
though I was just as smiling and pleasant as could be to her 
face.' 

" ' That's a good girl. You must always be very polite and 
cordial to your companions, you know. But I must say I 
think Nellie was quite vain ; and you must never show that 



1 8 The Mothers Hygienic Hand-book. 

you are proud of your clothes. I shall go out to-morrow and 
get that pretty dress you teased so for, I think." 

" ' Oh, mamma ! I am so glad ! And as soon as it is made 
I'll go right over and call on Nellie. Won't she feel bad when 
she sees my new dress ! It will be ever so much prettier than 
hers.' 

" And the mother smiled complacently, with never a thought 
of the improper and wicked feelings she was cultivating. Oh 
mothers ! How can you be so blind ! Both by precept and 
example you are teaching your children to make dress their 
idol ; and to know very little of anything but that which 
pertains to fashion ; to be envious or contemptuous of their 
little friends and companions, according as they are dressed 
better or worse than themselves. Can you ever reflect that 
God did not commit such treasures to your keeping without 
meaning some day to call upon you to render up the account 
of your stewardship? What can you say, when asked how 
you have trained the young souls given to your care ? Can 
you reply, We have been instant in season and out of season in 
teaching them — w T hat ? To w r ork for the good of others ■ to 
learn to do right ; in all simplicity to love and obey the 
Saviour, who, taking a little child in his arms, said, " of such is 
the kingdom of heaven.' ' Of such ? Ah, no ! Not of those 
children that you are training to avoid — not evil communica- 
tions, but unfashionable companions ; to look on the outward 
adorning, and not on the heart. 

" But it is not alone the wealthy, indeed, who make no pretence 
to any higher law than their own selfish gratification, who bow 
the knee to fashion. Christian mothers, are you guiltless? 
Think of the time, the health and strength, given to dress — 
the bondage which compels you to pervert all real taste, to do 
violence to your own natural instincts of neatness and true 
elegance, and accept the absurdities of fashion, simply because 
the ruling style requires it. If you are thus influenced and 
beguiled, do you flatter yourselves that your children will not, 
from their earliest years, regard such homage as important? 



Ante-natal Influences. 19 

We do not think it wrong to dress neatly and in as good taste 
as possible. We blame none for giving so much thought to 
their own dress and their children's as to provide those articles 
that are appropriate and becoming to the different styles of 
face, figure, and complexion. It is natural, and we think right, 
for a mother to dress her darlings as neatly and prettily as she 
can, without unnecessary waste of time and strength ; but we 
do think it sin to spend money and time lavishly in following 
the dictates of fashion, and not of good taste and common 
sense ; no one pretends to believe that there is either of these 
in the present style of dressing. It is utterly destitute of grace 
— is ridiculous to the last degree ; but fashion compels, and 
women — Christian wonien — obey, and teach their little daughters 
like obedience ! Oh, the money, time, and strength given to 
destroy, by the absurdities of fashionable dress, every vestige 
of beauty and grace which God gave you in your little ones ! 
Take the week through, hour by hour, do you not give more 
time and thought to your own and your children's dress, than 
you can spare for your Master's service? Do not your 
children gather from your daily walk and conversation that to 
be fashionably dressed is of more importance than loving and 
serving the Saviour, who died for them and you ? Judging by 
your daily conversation, which will they consider of the 
greatest importance — the service of God, or the devotion to 
Fashion ? To which do they see you giving the largest part of 
your time — the adorning of their little bodies — "the plaiting 
the hair, the wearing of gold, and putting on of apparel " — or 
in teaching them that which is not changeable " not corruptible, 
even the ornament of a meek and quiet spirit, which is, in the 
sight of God, of great price " ? What can you say, fashionable 
Christian mother, when he calls you to give an account of 
your stewardship ? 

It would seem that the moral considerations alone, so ably 
presented by Mrs. Beecher, ought to be sufficient to dissuade all 
mothers, and especially Christian mothers, from training theii 
daughters in these ruinous ways ; but, unfortunately, with a 



20 The Mother s Hygienic Hand-book. 

large proportion of the mothers of the present day, fashion is 
more regarded than judgment or conscience, and more deferred 
to than God or humanity. The physiologist, however, must 
take still another view of this matter. We know very well, and 
can prophesy with unerring precision, that no girl trained and 
educated in these evil ways, can be normal, either mentally or 
bodily, when she reaches the age of womanhood, and that she 
can by no possibility give birth to a child that is not more or 
less abnormal, both mentally and physically. It is impossible, 
in an organization so misused, for the germ of the future )?eing 
to be properly developed ; and without a sound germ unsound- 
ness will be manifested in the embryo, the child, the man, or 
the woman. The Health Reformer must begin his work with 
the newly-married couple, teach them to beget and rear children 
according to the laws of nature as manifested in the vital 
organism, instead of the laws of fashion as dictated by the 
vain and frivolous. 

It is a very prevalent error that persons may impair the func- 
tions of individual life without materially affecting the integrity 
of the reproductive organs. Many parents will eat and drink 
pernicious things, use liquor and tobacco, indulge the most 
violent passions, &c, with little or no thought that such practices 
and habits deprave and enfeeble their sexual powers. Here as 
every where, self-preservation is the first law. The individual 
must be first sustained. And however much unhygienic habits 
deteriorate the functions of individual life, the functions of 
social life will suffer still more. This is why so many persons 
of vigorous constitutions are the parents of feeble and sickly 
children. Many a mother breathes enough for herself, but not 
enough for the offspring during gestation ; and this comes into 
the world frail and scrofulous, like a plant that has grown in a 
situation deprived of light. 



Anatomy of the Uterine System. 21 



CHAPTER II. 

Anatomy of the Uterine System. 

Every mother, actual or prospective, should understand the 
structures and uses of her reproductive organs. These consist 
of the uterus, in which the foetus is nourished until birth, the 
ovaries, in which the germ, or egg, is produced, their appen- 
dages, and the mammary glands, or breasts which provide the 
infant with fluid food until its teeth are developed sufficiently 
to enable it to masticate solid food. 

The Uterus. 

The Uterus (womb,) properly the organ of gestation, is situated 
in the cavity of the pelvis (lower abdomen) between the urinary 
bladder and the rectum (lower bowel.) It is a pear-shaped 
sac, about three inches in length, two inches in breadth at its 
upper part, one inch in thickness, and weighs from an ounce 
to an ounce and a half. After child-bearing it is more globular 
in shape, and somewhat larger in size. Its upper broad 
extremity is termed, the fundus, its lower and narrower portion 
the cei'vix, or neck, and its opening into the vagina, the os 
uteri. The cavity of the uterus is small in comparison with 
the size of the organ. At the junction of the body and neck 
of the uterus, the cavity is constricted, constituting the os 
internum. The coats of the uterus are, an external serous, a 
middle muscular, and an internal mucous coat — the muscular 
coat forming the chief bulk of the organ, and, by contracting 
enabling it to expel its contents. The uterus is lined with a 
raucous membrane, which covers also the internal surface of the 
vagina and the Fallopian tubes. 

The uterus is supported in its position in the pelvic cavity by 



22 The Mothers Hygienic Hand-book. 

the upper portion of the vagina, whose fibres are connected 
with those of the neck of the uterus a short distance above the 
os uteri, and by six ligaments, two in front, two behind, and two 
lateral. These ligaments are formed by folds of peritoneum (the 
lining membrane of the abdominal cavity). The anterior liga- 
ments pass between the neck of the uterus and posterior surface 
of the bladder, and are hence termed vesico-uterine. The posterior 
ligaments pass between the sides of the uterus and rectum, and 
are termed, 7'ecto-uterine. The lateral ligaments are broad, and 
form a septum across the pelvis, dividing its cavity into two 
portions, in the anterior of which is contained the bladder, 
urethra, and vagina, and in the posterior, the rectum, 

The Ovaries, 

The ovaries are oval -shaped bodies, situated on each side of 
the uterus, in the posterior part of the broad ligaments, behind 
and below the Fallopian tubes. They are about an inch and 
a half in length, three-fourths of an inch in width, and one- 
third of an inch in thickness, and weigh from one-eighth to 
one-fourth of an ounce. Each ovary is connected, by an 
anterior margin, with the broad ligament; by its inner extremity 
to the uterus, and by its outer end, to the frimbriated (fringe- 
like) extremity of the Fallopian tube. 

In Structure each ovary consists of a soft fibrous tissue 
{Stroma), abundantly supplied with blood-vessels, imbedded in 
the meshes of which are numerous small round transparent 
vesicles in various stages of development \ a dense fibrous 
covering, termed tunica albug'mea, and an external investment 
of peritoneal membrane. The vesicles are termed Graafian, 
and are the ovisacs which contain the ova or eggs. As each 
Graafian vesicle enlarges, it approaches the surface, and, when 
mature, forms a projection on the exterior of the ovary, 
beneath the peritoneum, and finally, opening, allows the ovum 
to pass into the Fallopian tube, and thence to the uterus. 

The Ovum is a minute Spherical body, indeed microscopic in 



Anatomy of the Uterine System. 23 

size, measuring only ^h, to 3— of an inch in diameter ; and yet 
its structure is somewhat complicated. It consists of a~ trans- 
parent envelope externally, termed Zona fiellucida, or vitelline 
membra7ie ; within this the Yolk, or vitellus, a small vesicular 
body in the substance of the yolk, termed the germinal vesicle, 
and within this the germinal spot. The germinal vesicle is about 
•$Yl of an inch in diameter, and the germinal spot only from 

The Fallopian Tubes. 

The Fallopian tubes (oviducts) connect the uterus with the 
ovaries, their function being to transmit the ova from the latter 
to the former. They are two in number, one on each side, 
extending from the upper part of the body of the uterus to the 
side of the pelvis. Each tube is about four inches in length, 
and, like the uterus, is formed by serous, muscular and mucous 
coats. 

The uterine half of the canal of the tube is extremely small, 
hardly admitting a fine bristle ; it then enlarges gradually into 
a trumpet-shaped extremity, which is contracted at its termina- 
tion, leaving a small orifice {ostium abdominale) which communi- 
cates with the peritoneal cavity. It is because of this opening 
at the ovarian extremity of the tube, that internal injections into 
the cavity of the uterus may be dangerous, if not fatal, in 
relaxed conditions of the uterine structures. In such cases 
astringent and caustic drugs have been known to pass through 
the Fallopian tubes into the cavity of the peritoneum, occasion- 
ing inflammation and fever {peritonitis). 

Mammary Glands. 

The mamma, or breasts exist in a rudimentary state in males, 
and have been known, in a few instances and under very 
peculiar circumstances, to enlarge and even secrete milk. In 
the female they are two large hemispherical glands, each ex- 
tending from the sternum or breast bone to the axillae, and frorr! 



24 The Mother s Hygienic Hand-book. 

the third to the sixth or seventh rib. They are small before 
puberty, increase during pregnancy, atrophied in old age. 
The base of each mamma is nearly circular, and is separated 
from the pectoral muscle only by a thin layer of superficial 
fascia. Its outer suface is convex, presenting just below the 
middle of the organ, a small conical prominence, the mammilla, 
or nipple, which is surrounded by a colored tint. The areola 
in the virgin is of a delicate rosy hue ; in the second month of 
pregnancy it enlarges and becomes darker colored, and this 
dark tinge usually grows still darker during the whole period 
of pregnancy, becoming in some cases dark-brown, or even 
black. In cases of suspected pregnancy these changes of color 
are regarded as important symptoms, although they are by no 
means conclusive. I have known cases in which the fulness 
and tenderness of the breasts, the darkening of the areola, and 
the enlargement of the abdomen, were as perfect and prominent 
as in ordinary cases of pregnancy, without however, the fact 
or the possibility of pregnancy existing. 

The nipple consists of numerous vessels so interblended with 
muscular fibres as to constitute a kind of erectile structure. 
Numerous orifices on its summit are the apertures of the lactif- 
erous ducts. Numerous sebaceous glands exist near the base of 
the nipple and upon the surface of the areola. During lactation 
these glands become much enlarged, and present the appear- 
ance of small tubercles beneath the skin. Their .office is to 
secrete an oily substance which serves as a protection to 
the nipple in nursing. 



Displacements of the Uterus. 25 



CHAPTER III. 

Displacements of the Uterus. 

These complaints are becoming so common and are so 
unsuccessfully treated by most physicians, that their nature 
and principal symptoms ought to be briefly explained in a work 
of this kind. Those who desire more full information on this 
subject are referred to the Author's work entitled " Uterine 
Diseases and Displacements." 

The uterus may be displaced downward, forward, or backward, 
or it may be partially or completely inverted. The displace- 
ment downward is termed prolapsus or falling of the womb, 
forward anteversion, and backward, retroversion ; when the organ 
is doubled on itself, the malposition is termed anteflexion, or 
retroflexion, as the fundus inclines forward or backward. 

In order to comprehend the rationale of uterine displace- 
ments, it is necessary to understand the manner in which it is 
sustained in its normal position in the pelvic cavity, and the 
causes which render its supports unavailing. 

The chief support of the organ is by the attachment of its 
neck to the upper part of the vaginal canal. It rests in a 
measure on the upper part of the vagina, assisted somewhat 
by the various ligaments to maintain its central and upright 
position. It must be noticed also that the uterus is not fixed 
in this position ; on the contrary it floats loosely in the pelvic 
cavity, limited in its motions by the attachments and ligaments 
just mentioned. This moveable condition is essential for the 
purposes of gestation ; during pregnancy the organ is devel- 
oped to six or eight times its non-pregnant length and breadth, 
and rises up in the cavity of the abdomen to the umbilicus, 
enclosing a foetus weighing, at full term, six or eight pounds. 

It is evident therefore, that whatever increases the weight of 



26 The Mothers Hygienic Hand-book. 

the organ, or presses on it from above, or relaxes the vaginal 
canal below, or in any manner weakens the adjacent muscles, 
tends directly to its displacement. 

Sedentary habits, by weakening the whole muscular system, 
and especially the abdominal muscles, are causes of displace- 
ment. Constipation of the bowels, the invariable result of the 
ordinary dietetic habits of women, occasions an inflammatory 
condition of the mucous membrane of the vaginal canal, 
followed by leucorrhcea or " whites," relaxation of the 
structures, and more or less prolapsus. The fashionable style 
of dress, restraining the motions of the chest by corsets and 
tight lacing, and loading the hips with heavy skirts, presses 
the bowels down on the uterus, and the uterus sinks lower 
into the pelvic cavity. It is impossible for any woman who 
dresses fashionably for many years, especially if she com- 
mence before maturity, to be exempt from displacement of 
the uterus. A majority of such women have its attendant 
inflammation, and many of them ulcerations superadded. 

Another prevalent cause of displacements of the uterus is 
" forcing " or emmenagogue medicines, such as savin, rue, tansy, 
preparations of iron, iodine, aloes, &c. These drugs occasion 
congestion in the organ, and often induce hemorrhage which is 
mistaken for menstruation. If they are frequently repeated 
(and many females take the preparations of iron for months 
or years), the result is permanent congestion of the uterus. 
The organ is too heavy because of its accumulated blood, and 
its constant pressure on the vagina causes its fibres to stretch 
continually until finally the uterus settles down ( "falls" ) one, 
two, or three, inches, and perhaps, tilts forward or backward, 
or bends on itself, or even protrudes externally. 

The more prominent symptoms of displacement are, a sense 
of weight and dragging-down in the pelvis, weakness or aching 
of the small of the back, aggravated by standing ; more or less 
leucorrhceal discharge, and a feeling of " goneness " in the 
region of the stomach. There is considerable pain, tender- 
ness, heat and smarting at first, but in prolonged cases the 



Displacements of the Uterus. 27 

parts have become so paralyzed and benumbed by constant 
pressure that no local uneasiness is complained of except 
weakness, and a distressing, dull, heavy, dragging, sensation. 
These symptoms are always aggravated on going up or down, 
stairs, lifting, or straining in any way. 

When the uterus is displaced in the forward direction (ante- 
version) its pressure on the bladder occasions frequent desire 
to urinate, and when thrown backward (retroversion) it presses 
on the rectum causing difficult defecation. In cases of 
flexion the patient cannot walk without much pain and difficulty, 
and is frequently unable to walk or stand. Such patients have 
sometimes been confined to their beds for years, not having 
the power to sit up for a moment without assistance. 

Inversion of the uterus usually happens immediately after 
childbirth,in consequence of the attachment of the placenta to 
the fundus of the uterus, or to an extremely relaxed condition 
of the organ, or pulling injudiciously on the umbilical cord to 
remove the afterbirth. In some cases a large polypous tumor 
growing from the fundus of the uterus has inverted the organ. 

The remedial plan, in all cases of displacement, consists 
firstly, in avoiding all the producing causes, and secondly, in 
promoting in all possible ways the general health. A rigid 
perseverance in this plan for several months will, in most cases, 
be attended with great improvement, and in many cases rewarded 
with good health. Some cases, however, will require one, two, 
or three years to restore a comfortable degree of health. 

In cases of anteversion, retroversion, and inversion, special 
manipulations are necessary, such as only competent physicians 
can attend to. To those who desire full professional instruction 
of the subjects mentioned in this chapter, and in that on Men- 
strual Disorders, I recommend my work entitled, " Uterine 
Diseases and Displacements." 



,8 The Mothers Hygienic Hand-book. 



CHAPTER IV. 

Menstruation. 

The period of life at which the process of menstruation 
commences is called puberty. In the majority of cases men- 
struation commences between the ages of twelve and fifteen, 
although climate, and personal habits may render it earlier or 
later. It is well established that stimulating viands, whether 
of food or drink, or those mental vocations and excitements 
which are directed more especially to the sexual instinct, as 
novel-reading, render puberty precocious ; and just to the same 
extent anticipate the normal "change of life," besides 
abbreviating the period of the individual life correspondingly. 

Sufferings incalculable have been imposed on woman 
because of a mistaken theory in relation to the nature of men- 
struation. Until a recent period the process has been con- 
founded with or mistaken for the flux or hemorrhage which 
usually accompanies it • and even now some authors regard 
the menstrual blood as something peculiar. In ancient times it 
was regarded as an excretion — a purifying process preparing 
or cleansing the sexual organs for the work of reproduction. 
Some modern authors have regarded it as secretion, an idea 
quite as absurd as that of excretion. 

Ovulation. — Menstruation is ovulation. It means the 
passage of an ovum through the Fallopian tube. An ovum 
matures once in about twenty-eight days. It then passes from 
the ovary through the Fallopian tube into the uterus, and if 
not impregnated and fixed in the uterine cavity, it passes oil 
through the vagina. This process is menstruation. It may 
or not be attended with bleeding. But the hemorrhage is 
incidental, if not abnormal. Some women never lose any 
blood at the menstrual periods, and are said not to menstruate. 



Menstruation. 2 9 

But such women have had children, and have been healthy 
and vigorous ; hence they must have ovulated. Young girls 
have suffered of hemorrhage of the uterine system, which has 
been mistaken for premature menstruation ; and old ladies, 
after having passed the " turn of life," have had an accidental 
bleeding mistaken for a recurrence of the menstrual function. 

It may be questioned whether all the hemorrhage that 
attends menstruation is not pathological. I can see no reason 
why woman should bleed because of the process of ovulation 
more than that animals should, It is perfectly certain that the 
great majority of women in civilized life bleed excessively, and 
are debilitated thereby, and the fact that a few women have 
lived to a good old age, had several children, and enjoyed 
remarkable health, with no bleeding at all, is conclusive to my 
mind that all hemorrhage is abnormal. It is well known, too, 
that women, as a general rule, other circumstances being 
equal, are feeble precisely in the ratio that they lose blood 
during menstruation. Hence the common practice of trying 
to promote menstruation by forcing medicines is a mistake. 
It tends to induce chronic congestion of the uterus, conduces 
to displacements, and ulcerations, and establishes the hemorr- 
hagic condition. 

It is true that there is a special determination of blood to 
the uterine system during the process of ovulation, and so there 
is to the digestive organs after a meal of victuals ; but in 
neither case is the expulsion of the blood required. In the 
case of digestion the object of a special determination of 
blood to the digestive organs is, to supply the material for the 
secretion of gastric juice. In the case of menstruation the 
object of a special determination of blood to the uterine system 
is to supply material, in case the ovum is impregnated, for its 
nutrition and development. In neither case is it necessary 
that any blood should be lost. It accumulates dispropor- 
tionately in the vessels of the organs ; the material needed is 
taken from it, and the remainder passes on into the general 
circulation. 



30 The Mother s Hygienic Hand-book. 

But if these vessels are relaxed and weakened from any 
cause, or if obstructions exist In the vicinity, interrupting the 
circulation or preventing the return of blood through the veins 
to the heart, or if the system is plethoric, the accumulated 
blood will transude through the coats of the blood-vessels, and 
hemorrhage be the result. Hemorrhages from the stomach in 
indigestion would be as common as hemorrhages from the 
uterus in mis-menstruation, were as muah blood determined to 
the stomach during digestion as is sent to the uterine system 
during ovulation. But as the digestive function is performed 
several times a day, while the menstrual function is only per- 
formed once a lunar month, a much less quantity of blood is 
required at any one time, with less liability to extreme con- 
gestion. The facts that two ovaries generate eggs, that only 
one egg at a time is developed normally, and that the number 
of males and females are nearly equal, are presumptive at least 
that menstruation is alternate with the ovaries, each evolving 
the egg on alternate months, and that sex is inherent in the 
germ, one ovary producing male and the other female ova. This 
hypothesis also accounts for twins, triplets, &c, of one or of 
both sexes. In further confirmation of these views, I have had 
patients affected with painful menstruation, because of disease 
of one ovary, each other month, while on the alternate months 
the process was painless and normal. 

Impregnation. — Authors do not agree whether impregnation, 
in the human female, occur normally in the ovary or uterus. 
It is certain that it may occur in either, or in any part of the 
Fallopian tube ; for all that is required is the contact of the 
sperm-cell with the germ-cell, wherever that may be. Impreg- 
nation, however, is not conception. I am satisfied that the 
uterus is the organ in which conception (and probably impreg- 
nation) usually and normally takes place. The few and rare 
cases of extra-uterine fcetation seem to be the kind of exceptions 
that prove the rale. This subject is fully discussed in the 
author's " Sexual Physiology," to which work the reader 
who desires a summary of all that is known or believed 



Menstruation. 3 1 

in relation to the theory of reproduction is respectfully 
referred. 

The theory of impregnation is one of the unsolved problems 
in physiology. It is commonly believed that the male semen 
imparts an impulse, or " vivifying principle " to the ovum, 
which starts in it the process of development, until then 
dormant. But this method of " energizing " — this " mode 
of motion," fails to explain the resulting phenomena, while the 
resemblance, more or less, to both parents, proves to a demon- 
stration, it seems to me, that impregnation is a comminglement, 
or blending, of the male and female elements in the production 
of a new being. The ancient and original doctrine, therefore, 
that each parent contributes equally to the inception of the life 
of offspring, is undoubtedly correct. 

It is commonly supposed that impregnation cannot take 
place without a certain degree of "orgasm," or pleasurable 
excitement on the part of the female • but this opinion is 
entirely erroneous. Impregnation, followed by pregnancy, may 
occur when the woman is in a state of insensibility. All that is 
required, as just stated, is the meeting and interblending of the 
"spermatozoa" of the male with the ovum of the female. 

Conception. — Soon after impregnation — how soon is not yet 
very well understood — the ovum becomes attached to the 
surface of the structure adjacent, as in ovarian and tubal 
fcetation, or to the wall of the uterus in normal fcetation. 
This fixation is conception. The ovum may be impregnated 
and yet pass off, as in cases of hemorrhage or dysmenorrhcea ; 
or it may be destroyed by the acrid discharge of leucorrhcea ; 
or it may be expelled by violent exertions of various kinds, and 
no conception result. But if all the conditions are normal, the 
impregnated ovum soon becomes attached, and the process of 
development commences. This attachment is conception, 
properly so termed/ 

The place where the ovum is attached becomes the central 
point of the afterbirth — placenta and membranes — which is 
developed with the embryo for its protection and nourishment. 



The Mother s Hygienic Haud-bock. 



y& 



Usually this place of attachment is at or near the middle of 
the cavity of the body of the uterus. In some cases the 
attachment is at the top or fundus of the uterus, rendering 
the organ liable to inversion after the child is born, if the cord 
be injudiciously pulled upon. In other cases the attachment 
occurs at the lower part of the uterine cavity, constituting the 
" placental presentation " in labor. These facts, taken in 
connection with the menstrual flux, seem to indicate that the 
ovum is several days in passing through the uterus, and that, 
when impregnated, it attaches, at once or very soon, to the 
adjacent surface. This fact also explains the exceptional or 
abnormal fcetations termed "extra-uterine." 

Sterility. — The idea of barrenness in woman is usually con- 
nected with the notion that she is not susceptible of impregna- 
tion. This may or may not be the case. But sterility is much 
more frequently the result of causes which destroy the ovum 
or remove it, after it is impregnated, than of causes which 
prevent its impregnation. Excessive hemorrhage during the 
menstrual period may wash it away, acrid excretions as in 
leucorrhcea, may destroy its vitality, and inflammation of the 
mucous membrane of the uterus may prevent its attachment. 
These circumstances explain why it is that so many women 
who have been married for years without children, soon become 
pregnant after recovering good health. And it was fortunate 
both for them and their offspring, that they did not become 
pregnant sooner. We must never assume that there is any 
constitutional defect or organic impediment to pregnancy, so 
long as the woman suffers of any menstrual or sexual 
disorder. 

But there are cases in which sterility depends on mechanical 
obstructions or organic imperfections. An imperforate hymen 
may prevent the passage of the seminal secretion to the uterus ; 
the os uteri may be closed by concreted mucus or fibrinous 
exudations ; the cavity of the cervix uteri may be obliterated by 
a thickening of its mucous lining, the ovaries may be diseased 
and not develop a fertilizable ovum ; or the functions of 



Menstruation. 3 3 

individual life may be so feeble, as in chlorosis, that those cf 
reproduction are entirely powerless. In those cases the cause 
must be ascertained and the treatment predicated accordingly. 
For further information of this subject the reader is referred to 
the author's work already named, " Diseases and Displacements 
of the Uterus," and to his "Pathology of the Reproductive 
Organs." 

One very common cause of sterility, and one which is very 
generally overlooked, is fatness. A condition of plethora or 
obesity in unfavorable to generation, and if the obesity be 
extreme, pregnancy is impossible. Many farmers understand 
that fat animals will not breed, and the principle applies to the 
human female. The reason is, the adipose matter crowds the 
circulating vessels, diminishes the quantity of blood, and 
weakens muscular action, so that the ovum is imperfectly 
developed and inefficiently nourished, even if impregnated* 



34 The Mother s Hygienic Hand-book. 



CHAPTER V. 

Menstrual Disorders. 

Diseases of the sexual organs of woman (" Gyncecology ") 
are confessedly " opprobrium medicorum " — the disgrace of 
medical science. No diseases, on the whole, are treated so 
unsuccessfully, not to say injuriously, and yet their treatment 
constitutes considerably more than one half of all the business 
of the medical profession. This is a fearful fact, not only in 
view of a false healing art, but in view of the general ignorance 
of women in relation to those circumstances and habits which 
produce or destroy their health. There is no reason, except 
erroneous modes of life, and medical miseducation, why women 
should not be as healthy as men, why girls should not be as 
vigorous as boys, nor why the human mother should not be as 
capable of nursing and feeding her progeny as the animals are. 
Reason, superadded to instinct, ought not to diminish but to 
exalt her capacity in this respect. And so it would if she 
would follow the dictates of instinct and reason instead of the 
mandates of fashion. 

. The increasing prevalence of the diseases of women is 
appallingly attested by the rapidly increasing gynceological 
literature. The works that have been written on this subject 
within a quarter of a century, would make a library of very 
respectable size ; while within a few years have appeared the 
ponderous volumes of Scanzoni, Columbiat, Hewitt, and 
Thomas, the last two named being latest in date, and largest 
in size, extending to nearly one thousand pages, with hundreds 
of illustrations. One of the late works (Bennet's) devotes 
nearly four hundred pages to the subject of " Chronic Inflama- 
tions of the Neck of the Uterus." Surely there is something 
wrong somewhere. Either the fashionable habits of woman- 



Menstrual Disorders. 35 

kind are going on from bad to worse, or the fashionable 
methods of medicating their maladies are more than failures. 
I think the general ill-health of woman is due to both causes. 

The very latest work on the subject, that of Professor T. 
Gaillard Thomas, M.D., of the New York College of Physicians 
and Surgeons, recommends to the student, in addition to his 
own work of 784 pages, and more than 300 illustrations, the 
formidable list of thirty other standard authors ! 

As Health Reformers and Hygienic physicians are so 
frequently accused of fanaticism or exaggeration on the subject 
of unhygienic habits, it may be well to refer to what Dr. 
Thomas says on this subject. The following quotations, 
mainly on the subject of dress, are quite as strong, and a little 
more plain and outspoken than any thing that Hygienic 
authors have yet published. 

" The dress adopted by the women of our times may be very 
graceful and becoming, it may possess the great advantages of 
developing the beauties of the figure, and concealing its defects, 
but it certainly is conducive to the development of uterine 
diseases, and prove not merely a predisposing but an exciting 
cause of them. For the proper performance of the functions 
of respiration, an entire freedom of action should be given to 
the chest, and more especially is this needed at the base of 
the thorax, opposite the attachment of the important respira- 
tory muscle, the diaphragm. The habit of contracting the 
body at the waist by tight clothing confines this part as if by 
splints \ indeed, it accomplishes just what the surgeon does 
who bandages the chest for a fractured rib, with the intent of 
limiting thoracic and substituting abdominal respiration. 

" As the diaphragm, thus fettered, contracts, all lateral 
expansion being prevented, it presses the intestines upon the 
moveable uterus, and forces this organ down upon the floor of 
the pelvis, or lays it across it. In addition to the force thus 
excited, a number of pounds, say five to ten, are bound around 
the contracted waist, and held up by the hips and the abdominal 
walls, which are rendered protuberant by the compression 



36 The Mother s Hygienic Hand-book. 

alluded to. The uterus is exposed to this downward pressure 
for fourteen hours out of every twenty-four ; at stated intervals 
being still further pressed upon by a distended stomach. 

" In estimating the effects of direct pressure upon the 
position of the uterus, its extreme mobility must be constantly 
borne in mind. No more striking evidence of this can be 
cited than in fact, that in examining it by Sims's speculum, if 
the clothing be not loosened around the waist, the cervix is 
thrown so far back into the hollow of the sacrum as to make 
its engagement in the field of the instrument often very difficult, 
and that attention to this point in the arrangement of the 
patient will at once remove the difficulty. While the uterus is 
exposed by the speculum, it will be found to ascend with 
every expiratory effort, and descend with every inspiration ; and 
so distinct and constant are the rapid alterations of position 
thus induced, that in operations in the vaginal canal the 
surgeons can tell with great certainty how respiration is being 
affected by the anaesthetic employed. An organ, so easily and 
decidedly influenced as to position by such slight causes, must 
necessarily be affected by a constriction which, in autopsy, 
will sometimes be found to have left the impress of the ribs 
upon the liver, producing depressions corresponding to them. 

" No one will charge me with drawing upon my imagination, 
even in the remotest degree, for the details of the following 
picture, for a little reflection will assure all of its correctness. 
A lady who has habitually dressed as already described, 
prepares for a ball by increasing all the evil influences which 
result from pressure. Although she may be menstruating, she 
dances until a late hour of the night, or rather an early hour of 
the morning. She then eats a hearty supper, passes out into 
the inclement air, and rides a long distance to her home. 
This is repeated frequently during each season, until advancing 
age or the occurrence of disease puts an end to the process. 

" A great deal of exposure is likewise entailed upon women 
by the uncovered state of the lower extremities. The body is 
covered, but under the skirts sweeps a chilling blast, and from 



Menstrual Disorders. 37 

the wet earth rises a moist vapor, that comes in contact with 
limbs encased in thin cotton cloth, which is entirely inadequate 
for protection. It is not surprising that evil often results to a 
menstruating woman thus constantly exposed. 

"To a woman who has systematically displaced her uterus 
by years of imprudence, the act of sexual intercourse which, 
in one whose organs maintain a normal position, is a physio- 
logical process devoid of pathological results, becomes an 
absolute and positive source of disease. The axis of the 
uterus is not identical with that of the vagina. While the 
latter has an axis coincident with that of the inferior strait, the 
former has one similar to that of the superior. But let the 
uterus be forced down, as it is by the prevailing styles of 
fashionable dress, even to the distance of one inch, and the 
natural state of the parts is altered. The cervix is directly 
injured, and thus a physiological process is intensibly merged 
into one productive of pathological results. How often do we 
see uterine disease occur just after matrimony, even where no 
excesses have been committed! It is not excessive indulgence 
in sexual intercourse which so often produces this result, but 
the indulgence to any degree on the part of a woman who has 
distorted the natural relations of the genital organs." 

Chlorosis. — When the girl does not menstruate at the usual 
period of life, and manifests the indictations of defective de- 
velopment in a general frailty, the condition is termed chlorosis. 
From the pale, wan, bilious, and frequently greenish com- 
plexion, the affection has been termed " green-sickness." 
Chlorosis is not strictly disordered menstruation, for ovulation 
does not occur, nor are there any symptoms of the process. 
This malady illustrates the position I have heretofore advanced 
that, where the functions of the individual life are feeble, those 
of the social life will be still more defective. In chlorosis there 
is no attempt at the evolution of a germ-cell or egg^ although 
the ovaries may have developed to nearly the norma! size. 
The patient is cachectic. Her bowels are constipated, liver 
torpid, skin inactive, digestion imperfect, and blood deficient. 



38 The Mother s Hygienic Hand-book. 

And if the family physician is consulted he will probably 
diagnosticate, "want of iron in the blood," as though blood 
was a chemical compound instead of a vital combination, and 
prescribe, among numerous other drugs, some of the prepara- 
tions of iron, as though any living organism, except the 
vegetable kingdom, could appropriate, or in any manner use 
inorganic substances. 

Chlorosis does not consist in a want of any particular 
element, much less any inorganic element, but in the want of 
nutritive power. The patient needs power to digest and 
assimilate, not stimulating nor poisoning. And this will be 
found, if found at all, in Hygienic agencies ; never in drug 
medicines. The exercise of that common sense with which 
almost every woman is endowed, would do more for chlorotic 
patients than all the medical books that were ever written. 
They need abundance of exercise in the open air • frequent 
exposure to sunshine, a plain and simple dietary, in which 
unbolted and unfermented bread with plenty of fruit are 
the staples, and a daily ablution with tepid water. Special 
conditions, symptoms, or complications, may require spe- 
cial attention • but the above plan, perseveringly carried 
out, is all the remedial resource required in the great majority 
of cases. When pains' in the ovarian regions indicate the 
menstrual effort, it may be judiciously promoted by warm 
fomentations and tepid hip-baths, employed once or twice a day. 
Obstructed Meiistruation. — When the menstrual flux does not 
occur at the menstrual periods, although the other evidences 
of ovulation exist, amd the patient suffers in general health, or 
of local pains, the affection is termed obstructed menstruation. 
It has two forms, termed retention and suppression, to either of 
which the term amenorrhoea has been applied by authors. But 
it must be kept in mind by those who read medical books on 
this subject that nearly all of the causes mentioned, the symp- 
toms attending, and the treatment prescribed, pertain to the 
presence or absence of the incidental hemorrhage, and not to 
menstruation proper, or ovulation. 



Menstrual Disorders. 39 

In what is termed retention of the menses, the blood is retained 
in the upper part of the vaginal canal by an imperforate 
hymen, producing, at the monthly periods, a sense of weight or 
heaviness, swelling, and often a dropsical condition of the 
feet and ankles at night, and a fullness of the eyes and face in 
the morning. The treatment is mechanical or surgical. The 
membrane should be perforated or incised. The best opera- 
tion is a crucial incision with a scalpel or lancet. The operation 
may readily be performed through a speculum, and is neither 
painful, dangerous, nor difficult. Any expert and handy nurse 
can perform it as well as the regular surgeon. 

The term suppressed menstruation is applied to the suspension 
of the menstrual flux after it has occurred one or more times. 
The exciting causes are usually colds, over-exertion, mental 
shocks, or some other incidental occurrence. The chief 
symptoms are headache, difficult breathing, and palpitation of 
the heart. In severe cases there are cold extremities, sense of 
fullness and heat in the pelvis, and " rush of blood " to the head. 
As this affection depends on obstruction rather than debility, 
it may be relieved by fomentations to the lower abdomen, 
warm hip-baths, and hot and cold foot-baths. When the whole 
body happens to be feverish, the wet-sheet pack bath for an 
hour, the full warm bath for ten minutes, or the vapor bath for 
twenty minutes, will be found useful. # 

Painful Menstruation. — When the menstrual flux is attended 
with severe pain for one or more days, the affection is known 
as Laborious Menstruation , or dysmenorrhea. It is usually 
attended with considerable, and sometimes with excessive bleed- 
ing, but in some cases the hemorrhage is slight. In severe cases 
the patient will suffer excruciating agony for several days, and 
only find relief in hot applications, to relax the whole muscular 
system. The peculiarity of this form of mismenstruation 
consists in an inflamed condition of the mucous membrane of 
the uterus, attended with a fibrinous exudation analogous to 

* For full instructions in relation to all forms of bathing processes, see 
the author's recent work, entitled, " The Bath," &c. 



4-0 The Mother s Hygienic Hand-book. 

that of diphtheria or croup. This exudation often concretes on 
the mucous surface, and is expelled in fragments, or in the 
shape of a sac or cyst, attended with bearing-down pains like 
those of labor. When the adhesion is very firm the uterus will 
contract violently and spasmodically to remove it, and for 
hours, perhaps days, the sufferings of the patient will be 
terrible. The expulsion of the sac above mentioned has not 
^infrequently been mistaken for abortion. In mild cases the 
patient will suffer pain but a few hours, but will be weakened 
by the succeeding hemorrhage. The milder cases do not 
prevent pregnancy, which, by arresting the morbid excretion, 
proves an effectual remedy. In the severer cases pregnancy 
Is impossible. 

The successful treatment of dysmenorrhea requires the nicest 
adaptation of the bathing processes to the conditions of each 
case, and a rigid and persevering Hygienic regimen applicable 
to all cases. Full, hip, and foot-baths are all useful ; but each 
should be of the temperature most agreeable to the patient. 
As a general rule all bathing processes should be warmer in 
the early or spasmodic stage, and cooler in the later or 
hemorrhagic stage. Vaginal injections are also serviceable, 
and the temperature may be warm, tepid, or cool, as indicated. 
Drinking freely of warm water will often assist in overcoming 
the spasmodic action. 

All that can be done during the menstrual period is to 
relieve the pain as much as possible. The removal of the 
inflammation must be attended to between the paroxysms. If 
the patient be too feeble to take much active exercise, passive 
should be substituted, as riding, swinging, sailing, &c. The 
dietary can hardly be too plain. All irritants and condiments 
should be avoided, and even milk and sugar abstained from. 
Hard water is especially injurious in these cases, and the 
saleratus and soda so commonly used in cooking are very 
pernicious. 

Excessive Menstruation. — This term is a misnomer, for men- 
struation, being ovulation, can never be excessive except when 



Menstrual Disorders. 41 

two or more ova are evolved simultaneously. What medical 
authors mean by excessive menstruation is simply unusual 
hemorrhage — monorrhagia. It may be caused by obstruction, 
forcing the blood into the uterine vessels, or preventing its 
return, or by a weakened and relaxed condition of the vessels 
themselves. In some cases the bleeding occurs once in two or 
three weeks, having little or no regard to the ovulation. 
Indeed, this may occur at the usual periods, without noticeable 
pain, flux or disturbance of any kind, while the hemorrhage 
may occur quite irregularly as regards time and quantity. 

In the treatment of menorrhagia the dietary should be as 
rigidly simple as in cases of dysmenorrhcea, but the bathing 
processes should be as cool as the patient can bear without 
chilliness ; and the vaginal injections cool or cold. In cases of 
severe flooding pieces of ice may be introduced. The patient 
should keep the horizontal position, and avoid all sources of 
bodily or mental disquiet. When there is a sense of heat in the 
abdomen or pelvis, cold wet cloths should be applied, and fre- 
quently renewed. Some authors have recommended the free use 
of iced-water, ice-cream, &c, to restrain uterine and other 
internal hemorrhages, as well as the discharges of diarrhoea and 
cholera. But I am sure such practice is erroneous. It tends to 
determine still more blood from the surface to the congested 
internal organs, and to aggravate the hemorrhage. I have 
known many persons troubled with bleeding piles resort to 
iced-water and ice-cream, but always with injurious consequences. 

Vicarious Menstruation. — Another misnomer, for ovulation 
never takes place elsewhere than in the ovaries ■ but some 
patients are affected with hemorrhage from some other part of 
the body than the uterus, at the menstrual periods, and to this 
the term vicarious has been applied. Bleeding, during the 
process of ovulation, may occur at the nose, mouth, lungs, 
stomach, bowels, kidneys, or from ulcers or abraded surfaces. 
No special medication is required.. Restore the general health 
and this form of mismenstruation will disappear. 

Abnormal Cessation of Afenstr nation. — The " change," or 



42 The Mother s Hygienic Hand-book. 

" turn of life," in this climate, usually occurs from the fifty- 
fifth to the fifty-eighth year of age, and when attended with 
some new disease or abnormal condition is termed irregular. 
In these cases the menstrual flux may be irregular and change- 
able in time and quantity, or dropsy, glandular tumors, or 
spurious pregnancy may appear. The hemorrhage is often 
alternated with leucorrhcea. In very plethoric persons apo- 
plectic symptoms may be present. 

As with vicarious mismenstruation, the abnormal cessation 
only requires strict attention to the general health, with such 
measures to restrain hemorrhage as have already been 
indicated. 

Leiicorrhoea. — The discharge known as " whites " is the result 
of relaxation or inflammation of the uterine and vaginal 
mucous membrane. In the former case the discharge is 
mucous, and in the latter muco-purulent, and attended with 
more or less heat, smarting, and often a scalding sensation 
during micturition. Constipation of the bowels is the most 
efficient of any one producing cause of this distressing ailment. 
" A majority of women," says Bedford, in his Obstetrics, "pay 
little or no attention to the action of the bowels," and if their 
habits are sedentary, their diet mainly bakers' bread and cakes, 
shortcake, butter, biscuits, candies, and ice-cream, and their 
dress fashionable ; and if, moreover, novel reading or some 
similar dissipation which overheats the head and chills the 
lower extremities, is superadded, the female has a combination 
of causes that never fails to produce leucorrhcea, and usually, 
also, ulcerations and displacements. 

In relation to the treatment, all the remarks made under the 
heads of chlorosis and dysmenorrhcea will apply to leucorrhcea, 
with the exception of the heating appliances to allay pain. 
Tepid, cool, and sometimes cold hip-baths may be indicated, 
and cool or cold vaginal injections, or ice, as recommended for 
menorrhagia, are adapted to different cases, the rule here, as 
everywhere being, the greater the heat of the part affected the 
cooler should be the temperature of the water employed. 



Pregnancy. 43 



CHAPTER VI. 

Pregnancy. 

Pregnancy may be distinguished into uterine, extra-uterine 
and numerical, as the foetus is developed within or without the 
uterine cavity, or as the pregnancy consists of one or more 
foetuses or tumors. 

Uterine pregnancy may be true or false, as the uterus contains 
a developing ovum or a morbid growth. 

Extra-uterine pregnancy may exist in the ovary, Fallopian 
tube, abdominal cavity, or in the meshes of the muscular fibres 
of the uterus. 

Numerical pregnancy may be single, plural, or complicated, 
as it consists of one foetus, of two or more, or of one or more 
foetuses in connection with a tumor or morbid growth. The 
following table will exhibit these distinctions at a glance : 

!True — Fcetation. 
False — Non-foe tation. 

f Ovarian. 

Extra-Uterine. < , u ^ • \ 
j Abdominal. 

[ Interstitial. 

! Single. 
Plural. 
Complicated. 

Signs of Pregnancy. 

Of the many symptoms that pregnancy exists, only two, or at 
most three, can be regarded as conclusive ; all others are either 
presumptive or probable ; hence in doubtful cases, and in cir- 



44 The Mother s Hygienic Hand-book. 

cumstances involving character, social position, or prospective 
interests, we cannot be too careful in giving an opinion. The 
various indications of pregnancy may be classified and tabulated 
as follows : 



Presumptive. < 



Probable. 



r Non-Menstruation. 
Nausea and Vomiting. 
Salivation. 
Mammary changes. 
Secretion of Milk. 
Areola. 

Abdominal changes. 
Descent of the Uterus. 
GEdema. 

Shortening of Cervix. 
[ Hemorrhage, or " show." 



( Quickening. 
Positive. •< Ballotement. 

( Pulsation of cord. 

The presumptive and probable signs of pregnancy are liable 
to great diversity, according to the health and personal habits 
of the woman. Thus " morning sickness " for example, which 
is so common a symptom, seldom troubles women who diet 
properly ; and again, the " suppression of the menses " — mean- 
ing the cessation of the monthly hemorrhage — is frequently 
absent, in actual pregnancies, the hemorrhage continuing as 
usual during a part or the whole of the period of gestation. 

Cazeaux, who has written the most scholarly and accurate 
work extant on Midwifery, gives the following statement of the 
rational signs of pregnancy embracing the whole period : 

First and Second Months. — Suppression of the menses (many 
exceptions) ; nausea and vomiting ; slight flatness of the lower 
part of the abdomen ; depression of the umbilical ring ; swelling 
of the breasts, accompanied with sensations of pricking and 
tenderness. 

Third and Fourth Months.— Continued suppression of the 



Pregnancy. 45 

menses (a few exceptions) ; frequently, continuance of the 
nausea, and sometimes vomiting ; less depression of the umbili- 
cal ring ; augmented swelling of the breasts ; prominence of 
the nipples, and slight discoloration in the areola. 

Fifth and Sixth Months. — Sensation of quickening motion in 
the abdomen ; suppression of the menses continued (some rare 
exceptions) ; vomiting and nausea cease (a few exceptions) ; 
considerable development of the w r hole sub-umbilical region ; 
a convex, fluctuating, rounded abdominal protuberance, salient 
particularly in the middle line, and sometimes exhibiting the 
foetal inequalities ; the umbilical depression is almost com- 
pletely effaced ; the discoloration in the areolae is deeper ; 
tubercles elevated. 

Seventh and Eighth Months. — Suppression of the menses 
continued (exceptions very rare) ; active movements of the 
foetus ; disorders of the stomach cease (exceptions rare) ; 
abdomen more voluminous ; sometimes protusion or pouting of 
the umbilicus ; numerous discolorations of the skin of the 
abdomen ; sometimes a varicose and dropsical condition of the 
vulva and lower extremities ; extended and deeper discoloration 
of the areolae \ breasts still larger • nipples more prominent \ 
sometimes flow of milk. 

First Fortnight of Ninth Month. — Vomiting frequently recurs ; 
abdominal swelling increased, rendering the skin very tense ; 
difficulty of respiration • all other symptoms increase in inten- 
sity ; sometimes pain in the back, with other irregular pains. 

Last Fortnight of Ninth Month. — Vomiting often ceases ; 
abdomen fallen ; respiration easier ; great difficulty in walking ; 
frequent and ineffectual desire to urinate • hemorrhoids ; increase 
of the varicose and dropsical state ; pains in the loins. 

It will be noticed that some of the above symptoms are 
generally present, and others generally absent, and still others 
present or absent in exceptional cases. Many of them, there- 
fore, are no part of normal pregnancy, but are attributable to 
ill health or unhygienic habits. The " great difficulty in walk- 
ing," mentioned as belonging to the last days of gestation, does 



46 The Mother s Hygienic Hand-book. 

not belong to normal pregnancy. Many women are on their 
feet, and attending to their ordinary work or duties until the 
moment of the commencement of actual labor. I have known 
several such cases. Hemorrhoids are never caused by pregnancy, 
but are always the consequence of prolonged constipation. 
When they exist, however, they are liable to become very much 
aggravated during the last days of pregnancy. 

With healthy women the course of symptoms is as follows : 
On the occurrence of conception the menstrual flux ceases 
entirely, as do all indications of ovulation. In the second 
month the uterus settles down a little in the cavity of the pelvis, 
causing a slight flatness of the lower part of the abdomen, and 
some degree of depression of the umbilicus. There is also 
more or less enlargement of the breasts, with a feeling of ten- 
derness. During the third and fourth month the depression of 
the umbilical ring gradually disappears, the breasts continue to 
enlarge regularly, prominences appear on the nipples, and the 
areolae become slightly discolored. About the middle of the 
fourth month, but sometimes a little later, the motions of the 
child are felt in the abdomen, which motions are termed quick- 
ening. These motions may be very distinct and unmistakable, 
or very indistinct and uncertain, as the woman is thin or 
plethoric, or as the uterus contains a less or greater quantity 
of fluid. Soon after quickening there is a more considerable 
and rapid development of the whole abdominal region below 
the umbilicus. During the sixth month and especially toward 
the end of it, the middle of the abdomen becomes rounded and 
prominent, and when there is not too much fluid surrounding 
the foetus, its inequalities may be perceived by external manip- 
ulation, and sometimes by ocular inspection. In the seventh 
month the umbilical depression is effaced (and sometimes in 
the sixth month), the areolae deepen in color, the abdomen 
becomes more prominent. In the eighth month all of these 
symptoms become more prominent, the umbilicus pouts, and 
sometimes milk is secreted. In the ninth month the enlarge- 
ment of the abdomen renders the skin tense, and in latter part, the 



Pregnancy. 47 

upper part of the abdomen seems somewhat fallen, and if there 
was any appreciable difficulty of respiration previously, especially 
on making any violent or unusual exertion, it becomes easier. 
In the last days of pregnancy there are usually slight irregular 
pains or cramps in the pelvis, loins, and back, not sufficient, 
however, to disable the patient from performing her ordinary 
duties, and sometimes scarcely noticed unless the patient's 
thoughts are directed to the subject 

Ratio male of Quickening. — A very erroneous view of the 
rationale of what is called quickening, has long been enter- 
tained. It has been regarded as indicating the endowment of 
the animal life, or of the mental or soul element. Until then, 
foetal life was regarded as merely vegetative, and in no sense 
mental. The mistake consisted in supposing muscular motion 
to be under the influence of volition instead of organic instinct. 
The foetus is as much vitalized, and as much vegetative, at one 
period of development as another, from conception to birth. 
In the embryo state all its actions are instinctive. The soul 
and mental powers, whatever their nature or essence may be, 
are manifested only through the organs of the external senses, 
and tnese are not in action until the process of respiration 
commences. This idea is beautifully, although allegorically 
expressed in the familiar Bible quotation : " And God breathed 
into his nostrils the breath of life, and Man became a living 
soul" 

The crime of destroying foetal life after quickening (for then 
the foetus becomes a child.) is adjudged to be murder in the penal 
statutes of some nations, on the ground that, at that time, the 
transition from merely organic to human life occurs. So far as 
criminality is concerned, it is the same at any time before birth, 
after conception has taken place. From conception to birth is a 
continual process of development ; but when the muscular 
system is sufficiently developed, instinctive or " reflex " move- 
ments take place with the limbs whose motions, being felt by 
the mother, are termed quickening. 

Pregnancy may exist without any period of quickening; that 



4 8 The Mother s Hygienic Hand-book. 

is to say, the motions of a living and viable child may be so 
feeble as not to be noticed ; while spasmodic contractions of 
the abdominal muscles, or of the intestinal canal, may be mis- 
taken for motions of a child. 

Ballottement and Pulsation of the Cord. — In those few cases in 
which quickening is absent or too feeble to be decisive, and it 
is important to determine the fact whether pregnancy exist, 
resort should be had to ballotement, which means the movement 
of the body of the foetus, as it floats in the amniotic fluid. The 
detection of the ballottement is very easy ; the index finger of one 
hand is to be pushed to the lower part of the uterus just above the 
os uteri, and the other hand, expanded, applied to the abdomen, 
grasping the fundus of the uterus ; then by pressing the finger 
suddenly upward and forward against the body of the uterus, 
the foetus will ascend or move away from the finger, but 
immediately return. No tumor, nor other condition than preg- 
nancy, can occasion a similar motion from and against the 
finger, hence ballotement is decisive. 

Pulsation of the umbilical cord is also decisive, when it can 
be detected ; but as this is sometimes impossible, and generally 
uncertain, while ballottement is attended with no difficulty, it is 
not worth while to dwell upon it. 

Duration of Pregnancy. — The normal period of pregnancy is 
usually reckoned at ten lunar months, forty weeks, or two hun- 
dred and eighty days. Some authors, however, have collected 
statistics which seem to anticipate this time for a few days 
approximating the popular period of nine calendar months, 
which is 273 days. But there must always be some variation in 
consequence of the different habits of women, constitutional 
peculiarities, and various other circumstances. 

The extreme duration of pregnancy has long been a moot 
question, as has also the earliest period of pregnancy at which 
a viable child can be born. The general rule seems to be well 
settled that, of children born at the end of the seventh month, 
a majority may live, while of those born before that time a majori- 
ty will die •> hence, in cases of deformed pelvis, or other infirmi- 



Pregnancy. 49 

ties or diseases which render it impossible for the mother to 
be safely delivered at full term, premature or forcible delivery 
is effected at this time, as affording both mother and child 
a chance for life. 

The question of the legitimacy of a child and heir is sometimes 
presented for adjudication in the courts. One of the most 
notorious which is recorded in works on Medical Jurisprudence, 
is known as the Gardner Peerage Case, which was tried in the 
British House of Lords in 1825. 

"Allen Legge Gardner, the son of Lord Gardner, by his 
second wife, petitioned to have his name inscribed as a Peer on 
the Parliament Roll. The Peerage, however, was claimed by 
another person — Henry Fenton Tadis — who alleged that he was 
the son of Lord Gardner by his first and subsequently divorced 
wife. It was contended that the latter w T as illegitimate \ and* in 
order to establish this point, the evidence adduced was partly 
medical and partly moral. Lady Gardner, the mother of the 
alleged illegitimate child, parted from her husband on board of 
his ship the 30th of January, 1802. Lord Gardner went to 
the West Indies, and did not again see his wife until nth of 
July following. The child, whose legitimacy was disputed, was 
born on the 8th of December of that year. Therefore, the plain 
medical question, taking the extreme view, was, whether a child 
born 311 days after the alleged conception could be legitimate. 
The affirmative answer to this question would present a re- 
markable case of premature, or a still more remarkable case of 
protracted birth. There was no pretence of miscarriage or 
premature delivery, the child having been fully matured at birth. 
The main question, and the one adjudicated was, whether 
gestation could be protracted 311 days? Numerous medical 
witnesses testified in the case, comprising the principle obstet- 
ricians of Great Britain. But, as usual in medico-legal questions, 
their evidence was conflicting. Five of them denied the possi- 
bility of so prolonged a period of gestation ; while eleven of 
them expressed the opposite opinion. The decision of the 
House of Lords was in favor of the five witnesses, and against 

4 



50 The Mother s Hygienic Hand-book. 

the eleven. But the judgment was evidently more influenced 
by the moral than the medical testimony, as it was proved that 
Lady Gardner, after the departure of her husband, sustained 
adulterous relations with Mr. Tadis. 

We have testimony, abundant and unimpeachable, that 
gestation may be prolonged beyond 280 days ; but to fix any 
day between that and 311, and say that gestation cannot be 
prolonged one day more is certainly presuming too much. Yet 
the probabilities are that, not one case in a hundred thousand 
ever reached 300 days. But to be on the side of mercy in 
doubtful cases, the Code Napoleon has declared that a child 
born 300 days after the departure or death of the husband, 
shall be deemed legitimate. The following extract from Bed- 
ford's Obstetrics shows what possibilities in nature, or what 
probabilities exist for mistakes in the data of knowledge: 

" Dr. Simpson records, as having occurred in his own prac- 
tice, cases in which the period reached 336, 332, 324, and 319 
days. Dr Merriman, 298 days ; and Prof. Murphy, 297 days. 
Dr. Atlee reports two cases which nearly equalled 356 days each ; 
and Prof. Meigs publishes a case, which he deems entirely 
trustworthy, of 420 days." 

Liability to Pregnancy. — The ovum is liable to impregnation 
from the moment it emerges from its ovarian bed, until it is ex- 
pelled from the os uteri. But the time occupied in the passage of 
the ovum from the ovary to the external world varies greatly 
with different women. With women of the more vigorous con- 
stitutions and better conditions of health the average time may 
be ten or twelve days ; but with the more feeble, and especially 
those suffering of local debility of the reproductive organs, the 
time may be extended to twenty days. The time, therefore, in 
which women are liable to pregnancy varies from one third to 
two thirds of each calendar month. The average time is un- 
doubtedly less then half of each month. The statistics that I 
have collected on this subject make it about twelve days. It is 
probable that the menstrual flux ceases very soon after the ovum 
has reached the cavity of the uterus, hence the time that every 



Pregnancy. 5 1 

woman is most liable to conception is immediately after its 
cessation. Those who desire to become pregnant should there- 
fore avail themselves of this fact, observing at the same time 
all hygienic rules, and avoiding all sources of dissipation, bodily 
fatigue, or mental worryment. 

Extra- Uterine Pregnancy. The limits of this work will not 
permit of the detailed treatment of the rare and extraordinary 
cases which occur in obstetrical practice, and require special 
or surgical treatment. In all such cases competent assistance 
must be sought. But the conditions and indications of such 
cases ought to be understood by all women who aspire to or 
are liable to motherhood. Such knowledge may often serve 
to allay apprehensions, especially in first cases, of imaginary 
difficulties and' dangers. It may be a consolation also to 
know that there are many thousands of uterine pregnancies to 
every extra-uterine one. 

In ovarian pregnancy the impregnated ovum becomes attached 
to the ovary, and is there developed. It is not difficult to 
understand that, extreme congestion of the organs at the time, 
with the increased vital activity which is always coincident with 
impregnation, might prevent the ovum from moving, and supply 
the material for fixing it to whatever part or structure it then 
happened to be in contact with. 

In Tubal or Fallopian Pregnancy, the ovum may become 
attached and developed in any part of the tube. Thus far 
medical authors have recorded a greater number of tubal 
pregnancies on the left than- on the right side ; but I can see 
no practical bearing of this record. 

In Abdonii?ial Pregnancy, the impregnated ovum becomes 
deposited in some part of the abdominal cavity, and attaching 
itself to whatever structure is adjacent, passes through certain 
stages of development. It is the least fatal of all the forms of 
extra-uterine fcetation. 

In Interstitial Pregnancy the embryo is developed in the 
muscular structure of the uterus. In some way the ovum 
becomes imbedded in the muscular fibres of the organ, instead 



52 The Mothers Hygienic Hand-book. 

of remaining within its cavity. Many hypotheses have been 
advanced to account for this malposition of the impregnated 
egg y but none of them either satisfactory or instructive. The 
probability seems to be that a loose flabby condition of the 
organ, or superficial ulceration, is the essential cause. That 
the lodgment of the ovum in a depression or excavation 
caused by ulceration, would, by being soon covered by fibrinous 
exudations, or "coagulable lymph," and in the subsequent 
process of granulation and cicatrization, become embedded in 
the uterine wall, is certainly easy to imagine, and, moreover, 
has "probability in view." 

In all the forms of extra-uterine pregnancy, the development 
of the foetus and its appendages progresses in the same 
manner as in uterine pregnancy, with perhaps, some slight 
exceptions in the structure of the placenta. The ovum is 
enclosed in a cyst, which differs somewhat in the different 
kinds of extra-uterine pregnancy. This cyst represents the 
uterus. It may rupture at any time and cause dangerous 
hemorrhage. In all of these cases the uterus undergoes more 
or less enlargement, and most or all of the early symptoms of 
pregnancy will be present. But the foetal development rarely 
proceeds to the full term. It seldom goes beyond the fifth 
month, and is more frequently arrested at a much earlier 
period. But there have been instances in which the abnormal 
development has remained for several years, after becoming 
devitalized and changed into a fatty or stony matter, or 
become exsiccated and shrivelled. 

The special signs of extra-uterine pregnancy are, a tumefac- 
tion of the part where the ovum is lodged, with a sense of 
heat, fulness, weight, and pain ; all of these symptoms, however, 
are present in ovarian or other tumors. Until the period of 
quickening it may not be possible, on account of the enlarge- 
ment of the uterus^ to determine that pregnancy exists, or that it is 
extra-uterine. But at this time the ballottement will decide. In- 
termittent and spasmodic pains, sometimes attend the later period 
of extra-uterine pregnancy, somewhat analogous to labor pains. 



Pregnancy. 5 3 

For the treatment of extra-uterine pregnancies several opera- 
tions have been proposed, the best and safest of which is that 
of making an abscess over the tumor. By this means the 
malorganized mass may be removed by the process of suppura- 
tion, and the part heal by granulation. 

False Pregnancy. — This term has been employed in a very 
indefinite sense, and made to embrace all those substances 
expelled from the uterus which are called moles. But moles 
are divided into the true and the false. The true mole is a 
degenerated ovum, blighted at some stage of its development, 
and is hence the product of conception, and not a case of non- 
foetation or false pregnancy. The transformation of the foetus 
to the mole is doubtless one of the manifold results of inflam- 
matory action, which destroys the vitality of the foetus, and 
then produces, as in cancers, polypi, hydatids, vesicles, cysts, 
false membranes, &c, morbid changes of the structural 
elements. 

In most cases, after the death or metamorphosis of the 
foetus the uterus will expel it, amounting practically to a case 
of abortion or still-birth ; but in some instances, the mole will 
remain for years, and perhaps be expelled at some future time 
after normal childbirth, or months or years thereafter. Again, 
in a case of twins, one ovum may be fully and normally 
developed, and the other degenerate into a mole ; and this 
mole may remain in the uterus months or years after the birth 
of the developed ovum. The fancied resemblance of moles to 
certain repugnant featured animals, as lizards, frogs, monkeys, 
screech owls, &c, is doubtless attributable to the fact that they 
are formed of a variety of sizes, shapes, and figures. 

Spurious moles embrace every kind of tumor or substance 
formed in the uterus without impregnation, as polypi, fibrous 
growths, blood clots, membranous concretions, hydatids, 
acephalocysts, &c. Blood clots, and membranous cysts have 
been mistaken for abortions, with which, indeed, they are very 
liable to be confounded, unless the physician is careful in his 
diagnosis, and as these masses are frequently expelled by 



54 The Mother s Hygienic Hand-book. 

unmarried women, and even young girls, great caution is 
requisite in forming a judgment, and very great caution in 
expressing it. I have known several cases of dysmenorrhcea 
in which blood clots were formed and expelled, by the same 
uterine efforts that characterize labor j and the clots were so 
firm and solid as to excite the suspicion of the attendants that 
abortion had occurred. Some of these cases occurred with 
married and some with unmarried women. 

The term, false pregnancy, is only properly applicable to 
tumors and morbid growths that occur independent of sexual 
intercourse. 



Miscarriage. 5 5 



CHAPTER VII. 

Miscarriage. 

The latest authors apply the term, abortion, to the expulsion 
of the impregnated ovum at any time after conception before 
the termination of the sixth month, and the term, premature 
labor, to its expulsion at any time between the end of the sixth 
month and the ninth. The term miscarriage comprehends 
both. 

Causes of miscarriage. — The common causes of miscarriage 
are general or local debility, violent exertions, bodily injuries, 
mental shocks, excessive sexual indulgence, &c. Drastic 
purgatives, and mercurial medicines frequently occasion abor- 
tions. Large doses of quinine, tartar emetic, and other potent 
drugs administered in fevers very frequently cause the uterus 
to expel its contents at any stage of gestation. Frequent 
bleedings are mentioned by authors as among the causes. 
Emmenagogue medicines, cod liver oil, and the preparations 
of iron absurdly called " blood food," and common table salt, 
all tend to produce a putrescent condition of the blood, relaxation 
of the muscular tissue, and thus predispose to abortion. After 
miscarriage has once happened it is very liable to recur at about 
the same period of pregnancy, and thus become a habit, not 
easily interrupted without a rigid perseverance in " a life 
according to the laws of life." 

"Symptoms of miscarriage. — Pain and hemorrhage are the 
prominent symptoms, and constitute the diagnosis of miscarriage. 
They are preceded by an unusual sense of languor, uneasiness, 
and weariness, with aching or cramping pains in the back. 
These symptoms are succeeded, after a few hours or clays, by a 
slight discharge of mucus or blood from the vagina, and 
bearing-down pains. It is important to notice that, to indicate 



56 The Mothers Hygienic Hand-book. 

the commencement of the uterine effort to expel its contents, 
the pains have the bearing-down quality, as in labor at full term. 
They are owing to the same cause, contraction of the uterus. 
These pains are first felt in the back, extending around the 
loins to the abdomen, and down the thighs, recurring at regular 
intervals, and increasing in strength and frequency. In a 
majority of cases the pain is as severe and more prolonged 
than in labor at full term. 

Another frequent cause of miscarriage, not mentioned in 
medical books, and seldom if ever thought of by pregnant 
women, ought to be mentioned, I mean the use of ice-cream. 
Many women in the cities and large villages indulge in it daily, 
and some several times a day. It is also taken in connection 
with iced-water as a beverage, and as ice-cream is thirst 
provoking, the more of it taken the more cold water will be 
taken also ; and to aggravate the evil, those who indulge the 
most in cold iced-water and ice-cream are apt to indulge freely 
also in hot drinks — tea, or coffee, or both. Hot drinks relax 
the blood vessels, and very cold ingesta determine the blood to 
the central organs, thus inducing or aggravating visceral 
congestion, and predisposing to miscarriage. It is a preva- 
lent opinion that ice-cream and large draughts of very cold 
water have a tendency to contract the muscular fibres and 
blood-vessels, and thus restrain internal hemorrhages. But 
the practice is based on an erroneous theory. In order to 
restrain internal hemorrhage the blood should be determined 
to, not from the surface. 

In some cases the ovum or foetus is expelled with little pain 
and slight hemorrhage ; and sometimes the foetus is expelled 
while the enveloping membranes and placenta are retained for 
several days, to be passed off finally in a disorganized and 
putrescent condition with the lochial discharge. The hemorr- 
hage attending miscarriage may be much or little, but it seldom 
continues after the expulsion of all of the contents of the 
uterus. As a general rule, after the first month, the flooding is 
less the nearer gestation approaches maturity. 



Miscarriage. 5 7 

Differential Diagnosis. — It is important to ascertain, in many 
cases, whether the hemorrhage be from the uterus, and if so 
whether it indicates miscarriage or not. Bleeding during 
pregnancy may be occasioned by a polypous tumor, or a 
cancerous growth or erosion, or it may be only menorrhagia 
continued into or through the period of pregnancy, or the 
"menstrual flux," so-called, during pregnancy. Bedford says, 
" The discharge may be nothing more than menstruation, which 
sometimes occurs in pregnancy." It is time that the Professors 
of Obstetrics in our medical colleges, and the authors of our 
standard text-books on "The Principles and Practice of 
Midwifery," understood that bleeding is not menstruation, and 
that menstruation does not occur in pregnancy. 

The character of the pain is almost always a pathognomonic 
or decisive symptom. It is recurrent, distinctly paroxysmal, 
with intervals of perfect quiet, invariably centers towards the 
loins and hypogastric region (lower and middle part of the 
abdomen), and is, moreover, accompanied with more or less of 
the beariiig-down sensation peculiar to expulsive uterine 
contractions. Again, in menstruation attended with pain, and 
in what is called menstruation during pregnancy, the pain 
precedes the hemorrhage, and ceases as soon as the discharge 
occurs. In miscarriage the pain is not lessened by the 
hemorrhage. 

Prognosis. — Although miscarriages are exhaustive of the 
patient's vitality, they do not often terminate fatally. The 
principal danger is from excessive hemorrhage ; but as the 
blood-vessels, especially in the earlier stages of pregnancy, are 
not very much developed, the bleeding from them may be 
prolonged for days, or even weeks, without causing death. 
Again, the patient in miscarriage is less liable to the compli- 
cations of diseases, especially convulsions, puerperal fever, and 
inflammatory affections, than in ordinary cases of delivery at 
full term ; not, however, because the normal childbirth is more 
dangerous than abnormal expulsions of the foetus, but because of 
the unhygienic habits of most women during the latter months 



58 The Mothers Hygienic Hand-book. 

of pregnancy, and the pernicious methods of medication which 
are generally resorted to in order to relieve the maladies or 
inconveniences incidental to pregnancy. 

. When, however, miscarriage is induced by " puncturing the 
membranes " or other instrumental methods of the professional 
abortionist, there is great danger and double peril • for the 
process is liable to produce excessive hemorrhage, and liable 
also to be followed by severe inflammation. . The deaths which 
are frequently mentioned in the newspapers, and the arrest of 
some physician or abortionist in connection with the " taking 
off," fearfully attest the prevalence and the danger of this 
proceeding. 

Treatment of miscarriage. — The first consideration is perfect 
quiet. The following directions from the author's " Hydro- 
pathic Encyclopedia," perhaps cannot well be improved. "The 
patient should recline in an easy, recumbent posture, the wet 
bandage be applied around the abdomen, and changed several 
times a day, and two or three vaginal injections of cold water 
employed daily. When the flooding is excessive, and in case 
of internal hemorrhage, denoted by headache, great lassitude, 
shiverings, frequent and feeble pulse, and the patient becoming 
pale, exhausted, and faint, with a dark shade under the eyes, 
the tampon may be employed with advantage, or a silk 
handkerchief, wet in the coldest water, or inclosing a cylin- 
drical piece of ice or snow, may be introduced into the vagina 
as far as convenient ; it may remain for six or eight hours, and 
then be introduced again if necessary. Enemata of the 
coldest water are also valuable auxiliaries in severe cases. 
In all cases it is important to have the room well ventilated, 
and the patient placed on a cool and rather hard bed or 
mattress. The inexperienced attendant should not be unduly 
alarmed at the faintness which takes place after severe or 
protracted flooding, for it generally happens that this condition 
favors the formation of a clot or coagulum, which obstructs the 
bleeding vessels and effectually arrests the hemorrhage." 

Although the patient should always be kept as cool as may be 



Miscarriage. 5 9 

without discomfort, it is always better to avoid chilliness, and 
especially to obviate cold extremities. If the surface becomes 
chilly the blood is determined preternaturally to the internal 
organs ; and if the feet are cold the blood is pressed back, so 
to speak, upon the bleeding uterine vessels, and the hemorr- 
hage aggravated. I have more than once arrested uterine 
hemorrhage by means of a cold wet cloth applied to the 
abdomen, and a jug of hot water applied to the feet. 



6o The Mother s Hygienic Hand-book. 



CHAPTER VIII. 

Presentations and Positions. 

In the technical language of midwifery, presentation means 
the particular part of the foetus which is found at the upper 
strait during labor ; and the term, position, is applied to the 
situation or place of the presenting part. 

Obstetrical authors make many needless distinctions of 
presentations and positions, which serve more to confuse the 
student than aid the practitioner. Madame La Chapelle's 
classification of presentations is the best I have seen, and 
sufficient for all practical purposes ; and this makes only three 
divisions, viz., head, pelvis, and trunk. 

These presentations, with their sub-divisions, may be 
tabulated, and all seen at a glance : — 

f Feet. 
Pelvis. < Knees. 
[ Breech. 

Shoulders. 
Breast. 
Abdomen. 
Trunk. { Back. 
Loins. 
Hip. 
Neck. 

As delivery can usually be accomplished without assistance 
in all varieties of head and pelvic presentations, they are called 
natural by authors ; and as all kinds of trunk presentations, 



Presentations and Positions. 61 

except in rare cases, require manual or instrumental aid, they 
are termed unnatural. The proper terms are normal and 
abnormal. But, as there can be but one normal presentation, 
and that the best possible one for easy and safe delivery, all 
others are properly termed abnormal. The vertex presentation 
is the only normal one, and if all women were in all respects, 
and at all times, normal, there would never be any other. 
Abnormal presentations, though more or less difficult and 
tedious, are not, in a majority of cases, dangerous. There are 
few cases of face, feet, knees, or breech presentations that 
require any special aid or management on the part of the 
practitioner, except patience. But trunk presentations are 
always dangerous. The foetus lies across the abdomen, and 
cannot be delivered unless so changed that one or the other 
extremities are made to present ; that is, it must, if possible, 
be converted into a head or pelvic presentation. This some- 
times occurs by the " efforts of nature " alone, and the process 
is termed spontaneous evolution ; and it can often be accom- 
plished by judicious external manipulations. 

Rationale of Presentations. — The reason that the head 
presents normally is because the head, being the heaviest part 
of the foetus as it floats in the uterine cavity, naturally takes, 
in obedience to the law of gravitation, the lower part of the 
cavity ; and the reason that the vertex is more frequently 
presented than the face is because that part of the head more 
readily " engages," or passes into the cavity of the pelvis. The 
vertex is the upper and back portion of the head which, in the 
foetus is pointed, whereby it enters the pelvic cavity, and 
follows its curve on the principle of a wedge. It follows, 
therefore, that any other portion of the head, provided there 
was no lack of fluid for the foetus to float in, could not so 
readily pass into and become fixed in the channel. This is 
why vertex presentations constitute about nineteen-twentieths 
of all the cases, the others being the consequences of unhygienic 
habits or abnormal conditions. 

Frequency of Different Presentations. — It may be a consolation 



62 The Mothers Hygienic Hand-book. 

to the woman, in view of approaching confinement, to know 
how rarely, even in the artificial ways and bad habits of 
society, the different kinds of abnormal presentations, occur. 
Statistics gathered from hundreds of thousands of cases 
reported, present the following scale of chances : — 
Vertex, nineteen cases in twenty. 
Face, one case in two hundred and twenty-five. 
Breech, one case in fifty. 
Feet, one case in one hundred. 
Knees, one case in two hundred. 
Trunk, one case in two hundred and fifty. 
Of course, if all women would adopt the Hygienic system, 
with all their inherited infirmities and acquired diseases, the 
ratio of abnormal presentations would be greatly diminished. 
I have never known any except the vertex presentation, in 
cases where women tried, however imperfectly, to live hygieni- 
cally during pregnancy. 

Diagnoses of Presentations. — There are few cases in which 
the presenting part may not be ascertained without difficulty. 
The marks or points of the fcetal body are so distinct and 
peculiar that, in most cases, a touch of the finger determines 
its position. 

Vertex presentations are determined by the fo?itanelles, of 
which there are two, posterior and anterior. These fontanelles 
are depressions, or " soft places " in the skull, in consequence 
of the bones not having united. The ppsterior fontanelle is 
triangular, that is, the depression is bounded by the edges of 
bones resembling a triangle in shape." The anterior fontanelle 
is a crucial or quadrangular depression, that is, four angles or 
depressed lines can be traced from its centre at right angles. 
Between the fontanelles is a seam where the top lines of the 
fcetal head unite, termed sagittal suture, which can generally be 
traced some distance from the presenting fontanelle toward the 
other. Each fontanelle is not only distinguishable by its 
shape, but may be distinguished from any other part of the 
fcetal head or body by its pulsation. The motions of the brain, 



Presentations and Positions. 63 

as there felt through the integument, will correspond with the 
actions of the fcetal heart. 

Either fontanelle is conclusive of a vertex presentation, but 
only the posterior is normal, as this brings the back part of the 
head forward in delivery, while the anterior indicates the 
opposite, and necessitates a more tedious labor. 

Face presentations are recognized by the eyes, nose, and 
mouth. 

When the breech presents, the buttocks, with the cleft 
between, and the genital organs, readily disclose it. 

Feet presentations are known by the toes. The toes are 
distinguished from the fingers by being at right angles with 
the leg, whereas the fingers are continuous with the arm. 

The knees are detected by a rounded tumor, with the pro- 
jecting portions (condyles) of the thigh bone at the knee-joint. 

Trunk presentations are known by the absence of all the 
signs of other presentations, and by the presence of the ribs, 
vertebrae, or shoulder blade. 

Diagnoses of positions.— -The presentation, of course, deter- 
mines the position ; or, reversely, the position of the foetus 
causes a certain part to present ; hence, when the presentation 
is known, the position is known also. The important practical 
point in all cases is, whether the position is such that, in the 
process of delivery, the posterior fontanelle will come in front 
under the arch of the pubis. But, to understand the position 
in all cases, we have only to consider the relation of the 
presenting part to other parts of the body. Thus, if the 
posterior fontanelle presents, the face will be backward ; and if 
the anterior fontanelle presents, the face will be forward. In 
breech, knee, or feet presentations, there is no difficulty in 
determining the position, as the genital organs, knee-joint, and 
toes correspond with the anterior fontanelle, while the buttocks, 
concavity in the bend of the knee, and heel, correspond with 
the posterior fontanelle. 



6\ The Mother s Hygienic Hand-book. 



CHAPTER IX. 

The Foetus in Utero. 

In order to have an intelligible idea of the duties of accouch- 
eur, it is necessary to consider the condition of the foetus and its 
surroundings in the cavity of the Uterus at full term. The 
annexse, or appendages of the foetus are, 

JDecidua. 
Chorion. 
Amnion. 

( Liquor Amnii. 
Annexse. •< Placenta. 

( Umbilical Cord. 

The foetus floats in the fluid termed liquor amnii, surrounded 
by the membranes which enclose both. The decidua is the 
outer or external membrane, the chorion the middle one, and 
the amnion the inner one. The three together constitute the 
shell or envelope of the foetus. Before the completion of labor 
these membranes usually rupture and the liquor is discharged. 
In some instances the rupture takes place before the labor is 
so far advanced as to confine the patient to the bed, or even to 
the house ■ and in rare cases the membranes do not rupture at 
all, and the foetus comes into the world completely enveloped 
in its intra-uterine covering. In these cases the child is said 
to be "born with a veil" and wonderful things are predicated of 
the future of children thus accidentally introduced. They may 
be prophets, seers, fortune tellers, mediums, or anything else 
as remarkable and unusual as their manner of birth. # 

* The following article which appeared in a recent issue of the Golden Age, 
shows the superstitious notions which are still prevalent on this subject : — 
Born with a Caul. — " Those who search the columns of the London 



The Foe his in Utero. 65 

As the form and features of the new comer are easily distin- 
guished through the semi-transparent membranes, the idea of a 
vail is natural enough. But the attendant will of course at 
once " rend the vail," unless the muscular exertions of its 
contents produce that result, and bring the little stranger in 
contact with the atmosphere which is needed to inflate its 
lungs and make it " a living soul." 

The quantity of fluid contained in the amnion varies greatly 

Times for curiosities will meet with advertisements such as the following : 
" A child's caul for sale ;" "a child's caul to be disposed of ; a well known 
preservative against drowning, etc. ; price ten guineas." " To mariners, 
etc.: to be sold, a child's caul; price fifteen guineas." "To be sold, a 
child's caul ; to save gentlemen trouble; price thirty pounds." "A child's 
caul to be sold for fifteen pounds." Persons who know nothing of this 
subject may wonder what a child's caul may be. 

This name is given to a membrane which is sometimes found on the head 
of an infant at birth, nearly encompassing the head. It is a rare occurrence, 
and the rarity has led to great importance being attached to it. The child 
itself will be lucky ; and the owner of the caul in after years will be shielded 
from many troubles that affect his neighbors. The superstition came from 
the East, where it had its origin in remote ages. Many diseases were 
believed to be curable by the wearing of a caul ; and to this day some sailors 
— even English sailors in the second half of the nineteenth century — have a 
faith in the efficacy of a child's caul to preserve them from drowning at sea. 

Sir John Offley, of Madeley Manor, in Staffordshire, bequeathed a caul 
as an heirloom, in a will proved in 1658 : " I will and devise one jewel done 
all in gold, enamelled, wherein there is a caul that covered my face and 
shoulders when I first came into the world, the use thereof to my loving 
daughter, the Lady Elizabeth Jenny, so long as she shall live ; and after her 
decease, the use likewise to her son, Offley Jenny, during his natural life ; 
and after his decease to my own right heirs male forever ; and so from heir 
to heir to be left so long as it shall please God of His goodness to continue 
any heir male of my name ; desiring the same jewel to be not conceded 01 
sold by any of them." 

A child two years old fell into a well near Romford, and floated face 
uppermost on the face of the water, whence he was rescued by his mother. 
The good woman at once attributed the preservation of her boy to the fact 
that he had been born with a caul. The readers of Hood's " Whims and 
Oddities " will remember " The Sea Spell," in which, imitating the style of 
the old ballads, he narrates a sea story, but pokes his fun in every stanza at 
the superstition of the child's caul." 

5 



66 The Mother s Hygienic Hand-book. 

in different cases — from a few ounces to several pounds. In 
some cases the fluid which escapes after the rupture of the 
membranes, is so slight that the labor is termed " dry." But 
in other cases, several quarts may be suddenly discharged, and 
with such a gush as to alarm the patient and startle the young 
practitioner, unless both are prepared for such a contingency 
by understanding the possibility of its occurrence. 

A very large accumulation of liquor amnii can usually be 
ascertained before delivery, by the remarkable distention of the 
abdominal walls. 

Should the practitioner suspect sudden hemorrhage, he has 
only to inspect the clothing to see that the discharge is colorless. 

The " bag of waters" in the language of the parturient cham- 
ber, means the projecting portion of the membranes and the 
amniotic fluid, against or through the os uteri, during the 
progress of labor. This "bag," projecting in front of the 
presenting part of the foetus, constitutes a delicate and elastic 
wedge which greatly facilitates the dilation of the parts, and 
renders the delivery less tedious. Whenever the " waters " are 
prematurely expelled, the labor is more prolonged and painful. 

The membranes, from various causes, may be so tough and 
unyielding as to require to be ruptured by artificial means, an 
operation of no difficulty nor danger, and only requiring a few 
scratches of the finger nail, or a slight incision with a knife. 

The Placenta is termed the afterbirth, for the reason that it 
is, in all normal labors, not expelled from the uterus until after 
the child is born.. The placenta is only found in the human 
being and mainmiferous animals. 

It consists of a flat, spongy mass, of a circular or oval shape, 
and is the medium of communication between mother and 
child, supplying nourishment to the child during its inter-uterine 
life by means of the mother's blood. It usually measures about 
six inches in diameter, and is from an inch to an inch and a 
half in thickness at its center, gradually thinning to its circum- 
ference. 

The Maternal surface of the placenta is attached to the 



The Fee his in Utero. 67 

uterus, and the foetal surface is covered with the chorion and 
amnion. In some cases the placenta is attached near the 
os uteri, or even around it, constituting placental presentation, 
and endangering the life of the patient because of the excessive 
hemorrhage which is liable to occur, unless prompt and proper 
measures are resorted to. The placenta may also be so 
firmly adherent to the uterus, because of inflammation or pro- 
longed pressure, as to necessitate its detachment by artificial 
means. 

The Umbilical cord is the medium of communication between 
the foetus and placenta, one extremity being in connection 
with the umbilicus of the child, and the other attached to the 
placenta. It is composed of two arteries and one vein. It is 
usually about the diameter of the little finger, and its ordinary 
length is from fifteen to twenty inches. In rare cases it has 
been found only four or five inches in length, or extending to 
several feet. 

When very short, it is in danger of being ruptured before the 
child is born • and when very long, it may be coiled around the 
child's neck, or knotted upon itself. 

The arteries of the cord wind around it during its whole 
length, and in nine cases of every ten, according to the testi- 
mony of some authors, from left to right. 

The pulsations of the cord, always prominent while the child 
is alive and the connection unbroken, are occasioned by the 
action of the fcetal heart, and are more forcible as the child is 
more vigorous. A rule in obstetrical practice is, never to cut 
or tie the cord until its pulsation ceases, as it always does after 
the lungs of the new-born child are fully expanded. 

The Foetal circulation. — There is no more wonderful process 
connected with living beings than the fcetal circulation and the 
changes it undergoes at the moment of birth • and, although 
more theoretical than practical in a work of this kind, a brief 
explanation of it can hardly fail to give us exalted views of the 
Supreme Architect. 

In the adult, and in the child after respiration is established, 



68 The Mother s Hygienic Hand-book. 

the blood passes from the veins to the right side of the heart, 
thence to the lungs, returning to the left side of the heart, and 
thence through the arteries to all parts of the system. But, in 
the foetus, the blood passes from the right to the left side of the 
heart, and thence to all parts of the system, without passing 
through the lungs. For this purpose there is in the foetal 
heart, a communication or opening between the right and the 
left side, termed foramen ovale. As soon as the air expands the 
lungs this foramen is closed by a valve, and the current of 
blood passed on to the lungs, through which its course is con- 
tinued to the end of life. 

The least misadjustment of the delicate structures concerned 
in this process, or a moment's loss of time in their adaptation to 
to the new channel of circulation would result in instant death. 
Yet this accident is rarely if ever known to occur. In some 
few cases the valvular closure is not perfect, in consequence of 
which only a part of the general mass of blood passes through 
the lungs, resulting in imperfect aeration of the blood, and, in 
extreme cases, constituting the " blue disease "—cyanosis. 



Parturition. 69 



CHAPTER X. 

Parturition. 

The process of expelling the child from the uterus at full 
term is denominated parturition, or labor. No word could be 
more appropriate. It is work, effort. It is usually attended 
with pain, though not necessarily painful. It is a normal 
process, and, therefore, can only be painful in abnormal con- 
ditions. Almost every author of a work on midwifery has 
recorded cases of painless labor, and the current medical 
journals frequently mention them. Probably no physician 
of extensive practice has failed to meet with them. I have 
attended several such cases. 

Rationale of Labor Fains. — The cause or rather the occasion 
of the pain, is contraction of the uterus, and, therefore, to the 
accoucheur, labor pains and uterine contractions are synonymous 
tenns. But it is a great mistake to suppose that the degree or 
severity of the pains corresponds with the force of uterine con 
tractions. The contractions may be extremely forcible and the 
pains very slight, or the contractions may be very feeble and 
the pains intense. 

We see, in the various processes of manual labor, in the 
extraordinary feats of lifting, running, jumping, in gymnastic, 
and athletic performances, and in the violent efforts of " ground 
and lofty tumbling," that the muscles can be made to contract 
to the utmost without a particle of pain. And the uterus 
could never contract with force enough to cause pain, unless 
some disease or abnormal condition existed. If a person has 
a felon on the finger, or rheumatism in the hand, it would be 
extremely painful for him to lift the weight of a pound ; but if 
the part was sound he could lift with all his power with no 
other feeling in the finger or hand except a momentary sense 



yo The Mothers Hygienic Hand-book. 

of tightness or constriction, and he could repeat the process 
every few minutes without pain. Precisely so it is with the 
contractions (muscular efforts) of the uterus in delivery. If the 
parts concerned are in a state of inflammation, the agony may 
be terrible. If sound, the labor may be painless. 

Pain, during labor, like diseases attending pregnancy, is 
attributable to morbid conditions. With most women there is 
more or less of sexual disease, usually chronic inflammation, 
rendering the parts sore, tender, and the necessary motions or 
stretchings correspondingly painful. Again, if the abdominal 
muscles are weak or torpid, as with many women of sedentary 
habits, they will not co-operate with the uterus in its expulsive 
efforts, in which case the contractions of the uterus will be 
irregular and spasmodic, greatly aggravating the pains. In 
some such cases the pains are excruciating. 

When the abdominal muscles are strong and elastic, as they 
are in all persons who have what may properly be called good 
health, they support the uterus in all positions of the body, and 
aid its expulsive effort so as to give them proper direction and 
effect. But if they are lax and feeble they may not only fail to 
sustain and assist the uterine efforts, but will act irregularly and 
spasmodically, thus embarrassing the bearing-down or expulsive 
efforts of the uterus. This is one of the chief reasons why 
laboring women, who are on their feet most of the time, have 
easier labors and less frequent accidents and complications than 
those who are idle or sedentary. 

Divisions of Labor Pains. — Labor pains are distinguished into 
the true and the false. The following table shows the distinc- 
tions with the symptoms pertaining to each : — 

5 Contractile. 
Recurrent. 
Bearing-down. 

! Non-contractile. 
Irregular. 
Spasmodic. 



The Foehcs in Utera. 71 

In true labor pain the whole body of the uterus contracts, 
while the opening or mouth (os uteri) dilates. The effect is to 
diminish the whole cavity of the organ and force its contents 
toward, into, and finally through the os uteri. The dilation of 
the os uteri if aided also by the " bag of waters " being pressed 
into it, and after the " bag " has been ruptured and the fluid 
discharged by the presenting partjof the foetus, which acts like 
a wedge. As the vertex of the head is most perfectly adapted 
to answer the purposes of a wedge, fitting perfectly to the 
somewhat devious channel through which the foetus passes in 
delivery, it is easy to understand why all other positions should 
be abnormal, and more or less difficult if not extremely 
painful. 

This equal uniform contraction and pressure on the os uteri 
is the cause of the bearing-down sensation, which, when distinct 
and prominent, always determines the woman to be in labor. 
It may be recognized by the experienced accoucheur on merely 
looking the woman in the face during the uterine contraction, 
for, in spite of all her efforts to the contrary, she will clench 
her hands, shut her mouth firmly, and hold her breath, until 
the uterus relaxes. Real labor pains, moreover, occur at 
regular periods with intervals of perfect quiet. If an examina- 
tion is made it will be found that, during each pain, or con- 
traction, the presenting part is pressed firmly against or into 
the os uteri, and that, as soon as the pain, or contraction 
ceases, the presenting part recedes. We see, then, how perfect 
is the arrangement for labor to go through its different stages 
safely and painlessly when all the conditions are normal. The 
uterine contractions commence gently; the patient experiences 
a slight sense of pressure all through the abdomen tending 
downward; the contractions become more frequent, and the 
sense of pressure increases ; in due time the sense of pressure 
becomes a decidedly bearing-down effort, which gradually in- 
creases in frequency and force to the end of labor. Thus the 
parts are distended by gentle efforts with intervals of rest, so 
that, if nothing exist or occur to disturb the harmony of the 



72 The Mother s Hygienic Hand-book. 

process, there will be little or no pain, however great the 
muscular effort. 

Signs of Labor. — The nature of the pains already described 
will determine the fact whether the woman is actually in labor. 
But there are preliminary symptoms indicating that labor may 
soon be expected which should be understood. Authors 
distinguish the preliminary or preparatory symptoms from the 
essential or expulsive symptoms. They may be grouped 
as follows : — 

Uneasiness in the pelvis. 
Obliteration of the neck of the uterus. 
Irregular abdominal and pelvic pains. 
Preliminary. \ Descent of the uterus. 
The os uteri accessible. 
Mucous discharge from the vagina. 
Tenesmus of the bladder or rectum. 



Essential. 



Bearing-down pains or efforts. 
Dilatation of the os uteri. 
" Show," or bloody discharge. 
Presence of Bas; of Waters. 



Preparation for Labor. — Probably there never was a mother 
who had the wherewithal who did not make ample provisions 
in the " little things " to dress and adorn the expected visitant. 
On this subject, therefore, nothing need be said. But to enable 
the patient to be in the best condition for parturition, a few 
words may be advisable. Above all things let her maintain a 
calm, cheerful, hopeful mind. If it be a first pregnancy let her 
remember that her chances are one hundred to one to get 
along without any serious difficulty, and a thousand to one to 
get through without dying provided there is difficulty. She 
may be further consoled with the reflection that all her atten- 
tions to hygienic rules during pregnancy, and even before, will 
render the chances of suffering and clanger still less. 

It is important that she exercise as much on the feet as she 
can conveniently, up to the very moment that labor commences ; 
nor should she then take to the bed or the chair, until obliged 



T/i c Feet us in Utcro. 73 

to. Regard to this rule may be the difference between a 
normal presentation and easy labor, and an abnormal presen- 
tation with intolerable suffering. Many women are enjoined, 
by their medical advisers to "keep quiet" as labor approaches, 
and in rocking chairs at that. The practice is pernicious and 
may be disastrous. Sitting in a rocking chair and leaning 
forward, or in any manner pressing the chest upon the abdomen 
is liable to cause a malpresentation, and perhaps a trunk pre- 
sentation, in which the foetus lies transversely instead of per- 
pendicularly with regard to the uterine cavity. 

As soon as the pains, or contractions, become decidedly 
bearing-down, the bladder and bowels should be emptied. 
There is usually an inclination to defecate at this time ; but if 
not, the bowels should be moved with an enema of tepid 
water. No food should be taken after labor has commenced, 
and but very little after the first preliminary symptoms, nor 
should the patient drink anything, not even pure water, more 
than actual thirst demands. Loading the stomach with either 
food or drink at this time, as is the manner of some, on the 
mistaken notion that they need extra nourishment for an 
extraordinary occasion, is a pernicious custom. The woman 
wants all the freedom from obstructions, and from other work, 
digestion not excepted, possible, throughout all the domain of 
organic life. No one would think of giving a race-horse, or a 
" walkist," or a gymnast, or a tumbler, or a pugilist, " extra- 
feed," when he was about commencing his unusual performance. 
In all these cases it is well understood that, to give the muscles 
all possible play and power, the stomach and bowels must be 
comparatively free. The same common sense should be 
exercised in the better business of having children. 

Preceding Dietetic Habits. — Though not strictly in order, it 
may be quite proper in this place to refer to the important 
subject of dietetic habits during pregnancy, for it is during the 
hours of labor that a woman experiences the culmination of all 
the good or evil effects of her dietetic habits, whatever they 
may have been. She may live as simply and hygienically as 



74 The Mother s Hygienic Hand-book. 

she pleases at all times, and be the better for it, but it is especially 
important, if she would have a " good time " through delivery 
and the lying-in period, and be exempt from the usual accidents 
and complications, such as prolonged suffering, hemorrhage, 
convulsions, inflammation, puerperal fevers, broken breast, &c, 
that her dietary, during the later period of pregnancy, should 
consist largely of good fruits, with a moderate allowance of 
fresh vegetables, and bread made of unbolted and unleavened 
meal. If animal food is used, it should only be fresh meat, 
taken moderately once a day. Every thing in the least 
constipating should be avoided. All high-seasoned dishes, 
pickles, salted meats, starchy preparations, sugar, fat, cheese, 
candies, ice-cream, &c 3 should be abstained from. These 
things not only render the uterine system and external organs 
of generation tender and inflammatory, but they increase the 
rigidity and hardness of the bones of the fcetal head, thereby 
causing a double obstruction to normal delivery. 

Stages of Labor. — As Labor, under normal circumstances, is 
one continuous process, from the first contractile effort to the 
final expulsion of the foetus, the distinctions of labor into 
periods or stages must, of course, be arbitrary \ nevertheless, 
it is convenient to make these distinctions. They may be 
tabulated thus : — 

( i. Dilatation of the os uteri. 
Stages. < 2. Delivery of the child. 

( 3. Expulsion of the afterbirth. 

We have already considered the mechanism of the dilatation 
x)i the mouth of the womb. When enlarged to the size of a 
half dollar labor may be regarded as established beyond all 
peradventure. The chief work of labor is to accomplish the 
full dilatation of the os uteri; for when the head passes through 
it, the delivery is nearly completed, the expulsion of the body 
usually following with one or two contractions. The expulsion 
of the afterbirth may follow in a few minutes, or it may be 
retained indefinitely. 



The Foetus in Utero. 75 

Examination Per Vaginam. 

The explanations given in this work are not expected to 
supersede the necessity of employing physicians in unusual or 
abnormal cases, but to be sufficiently minute to enable a com- 
petent nurse, or any intelligent woman, to render all the 
assistance necessary in normal labors, when a physician cannot 
be had, or is not desirable. And it seems to me that every 
woman, married or single, ought to understand the subjects of 
normal pregnancy and childbirth in all their details, as much 
as they understand, or should, the processes of making clothing, 
preparing food, or training children after they are born. 

In order to ascertain the stage or progress of the labor, and 
the presentation and position of the foetus, the index finger of 
the right hand, previously oiled, is introduced into the vagina, 
and pushed upward and backward until it comes in contact 
with a tumor. This tumor is the uterus. The finger may or 
may not come in direct contact with the os uteri. If not, this 
is to be found by moving the point of the finger in various 
directions. In almost every case, when the finger first comes 
in contact with the round globe of the uterus, the os uteri will 
be found far back and high up in the pelvic cavity — as far as 
the finger can reach. Dr. Verdi, in his late work, " Maternity," 
in instructing the nurse how to make a vaginal examination, 
says : " If she is in doubt whether her finger is in the mouth of 
the womb, let her keep it within until a pain comes on, and, if 
the finger is within the womb, she will feel the mouth contract 
around it like the string of a purse." 

I have always found it just the contrary. In uterine con- 
tractions the muscular fibres of the body of the uterus 
antagonize those of the os uteri ; hence, when the pain is on 
the os uteri dilates instead of contracts. If the finger is 
within the mouth of the womb, it will recognize a tumor within 
a tumor. The presenting part of the foetus will be felt sur- 
rounded by a ridge which is the edge of the mouth of the 
womb. When the pain is on the presenting part, or the bag 



76 The Mother s Hygienic Hand-book. 

of water in front of it, will be pressed firmly against the edges 
of the os uteri, so that, between the os uteri and presenting 
part is only a very slight depression. But when the pain is 
off the uterus is relaxed, and the presenting portion is moveable, 
so that the finger can readily describe a circle between it and 
the os uteri ; and if the os uteri is sufficiently dilated, ascertain 
what part of the foetus it is that presents. 



Diseases during Pregnancy. 77 



CHAPTER XI. 

Diseases during Pregnancy, 

There are some accidents and disorders attending pregnancy 
and parturition which require prompt attention, but do not 
necessarily call for the services of the professional obstetrician 
nor the operative surgeon. These it will be convenient to 
consider in the present chapter. 

Morning Sickness. — This is one of the earliest incidents of 
pregnancy, although it does not always occur. It is immedi- 
ately occasioned by the disturbance of the adjacent organs, 
consequent on the enlargement of the uterus in the pelvic 
cavity. To relieve it the dietary should be dry and solid. The 
food should be eaten very slowly, thoroughly masticated, and 
taken without drink. Wheat meal bread, or crackers, with 
baked potatoes, and a good apple, would make a suitable meal. 

Nausea and Vomiting. — As pregnancy advances these affec- 
tions sometimes become very annoying and persistent. They 
are chiefly induced by constipated bowels, or a torpid liver, 
and bilious condition of the blood. Strange as it may seem, 
some authors of reputation regard vomiting as a normal and 
necessary incident of pregnancy, as though pregnancy were 
abnormal, and it is healthy to be sick ! Dr. Bedford remarks 
(Principles and Practice of Obstetrics) : " I hold that the 
nausea and vomiting of pregnancy, under ordinary circum- 
stances, instead of being regarded as pathological, are, in 
truth, physiological phenomena." When the medical profession 
learns the true theory of disease, it will cease confounding 
pathological and physiological phenomena. It is no more 
physiological for a pregnant woman to be sick than for an 
non-pregnant one. 

Dr. Bedford explains : " As soon as impregnation takes 



78 The Mother s Hygienic Hand-bock. 

place the uterus becomes suddenly congested, and this tendency 
of the blood towards the organ continues in unbroken currents 
until the completion of gestation. Without some derivative 
influence in the earlier periods of pregnancy, to hold in salutary 
check this determination of blood towards the uterus, its nervous 
structure would become so overwhelmed and irritated that 
premature action of the organ, and expulsion of its contents, 
would be the consequence. In order, however, to guard against 
such contingencies, nature has found it necessary, in the plan 
of her operations, to institute two phenomena — nausea and 
vomiting — the direct result of which is, for the time, to produce 
relaxation of the general muscular tissue, and increased 
activity of that essential einunctory — the perspiratory surface." 

It seems to me that nature's plan of operations would be 
vastly simplified if it sent less blood to the uterus — just the 
quantity required for use. And that is just what nature does 
do, in all healthy women. The excessive quantity of blood, or 
congestion, is always the result of obstruction and disease. 
Dr. Bedford proposes to " aid and assist nature," in the cases 
in which she fails to institute the phenomena of nausea and 
vomiting by administering "minute doses of ipecacuanha to 
induce an irritable condition of the stomach." 

The better management is to free the bowels with enemas of 
tepid water, and open the pores of the skin by means of tepid 
ablutions, followed by active friction. Sugar, grease, salted 
meats, &c, should also be excluded from the dietary. 

Morbid cravings. — In some cases the pregnant woman has 
longings or cravings for the most improper and unwholesome 
articles, and it is a moot question among physicians and nurses 
whether they should or should not be gratified. Here, as every- 
where, circumstances alter cases. There may be desires for 
certain articles of food or drink which are not strictly hygienic, 
where indulgence would be the lesser of two evils. But the 
rule, I am persuaded, is the contrary. There is a general 
prejudice among women, which is shared by some physicians, 
that the refusal of any article for which the pregnant woman 



Diseases during Pregnancy. 79 

has a longing, endangers the "marking of the child." Admit- 
ting the possibility of this result, I think the greater danger is 
in damaging its organization by the indulgence. Due attention 
to the general health, a little mental effort in the direction of 
wholesome things, and that degree of self-denial which all 
persons should be capable of exerting, will overcome all morbid 
cravings, or render them harmless. 

Mother marks. — Authors are not agreed whether strong 
mental impressions, or shocks, during pregnancy, can cause 
spots, blemishes, deformities, &c, in the offspring — nevi matemi. 
Some cases seem to be well authenticated, and almost every 
mother has seen or heard of one or more individual cases 
which settle the question in her mind. However this may be, 
it is perfectly certain that all powerful emotions, caused by 
frightful, disgusting, strange or pitiful objects, affect the health 
of both mother and child injuriously. And the practical 
application of this fact is, that all such things should as much 
as possible be avoided. Pregnant women should not attend 
any theatre when tragedies like Virginius, Othello or Richard 
the Third are played, nor an}' spectacular performance where 
scenes of fear, suffering, or fright, are represented ; and it is 
wrong to allow cripples, and diseased and deformed persons, 
to be on exhibition in the streets, for the reason, among many 
others, that their appearance and pitiful appeals may excite the 
imagination of the woman, when in the susceptible condition of 
the early months of pregnancy, especially in a first case, to that 
degree that she cannot avoid dwelling on the disagreeable 
subject or object for days or weeks. A true civilization would 
never allow beggars or cripples to ply their vocation in the 
public thoroughfares. 

Toothache. — Those who are predisposed to this affection are 
liable to its recurrence on becoming pregnant. Freeing the 
bowels, and living abstemiously, for a day or two, will relieve it. 
It can often be removed at once by holding warm, tepid, cool, 
c • cold water in the mouth. Experience will soon determine 
the temperature that is most agreeable. 



8o The Mother s Hygienic Hand-book. 

Cramps. — Are among the frequent troubles of the earlier 
months of pregnancy. They are occasioned by pressure of the 
enlarging uterus before it rises out of the pelvic cavity. They 
affect the woman less at mid term, but are liable to be severe 
near the time of confinement, on account of the pressure of 
the uterus as it descends toward the pelvic cavity, where it may 
press painfully on the sacral nerves. To lessen the suffering 
as much as possible, and perhaps obviate it entirely, the woman 
should avoid sitting much of her time, especially in a rocker 
or in any leaning position. While liable to cramps she had 
better keep on her feet as much as possible without fatigue, 
and when tired lie down on a flat bed, or mattress, with the 
head only moderately raised, until rested. Of course the 
bowels should be kept free, and all causes of obstruction 
avoided. 

Constipatiofi. — As this is the most prevalent morbid condition 
of all women in civilized society, it is also an ailment of every 
pregnant women who "lives as others do " — reckless of hygienic 
habits. Those women who are habitually constipated will 
almost always have this condition very much aggravated in the 
early months of pregnancy. In severe cases intussusception of 
the bowels is liable to occur, producing the most violent retchings 
and vomitings for days or weeks. The remedial plan consists 
of enemas of tepid water, and a dietary in which wheat-meal 
bread and good fruits are the leading articles. 

Piles. — Hemorrhoidal tumors are always the result of habitual 
constipation, and are very liable to re-appear or become 
aggravated, on the occurrence of pregnancy, if the woman 
has been previously affected with them. Not unfrequently 
they are first noticed some time during gestation ; and some- 
times they are exceedingly distressing as labor comes on. 
Moderately cool hip-baths, enemas of small quantities of cold 
water, and the application of cloths wet in cold water to the 
part are the remedies. 

Pruritus. — A distressing irritation and itching of the genital 
organs occasionally torments the pregnant woman. Cloths wet 



Diseases during Pregnancy. 81 

with tepid or warm water are the proper applications. In most 
cases warm water is more soothing than cold. 

Heartburn. — This affection is caused by acidity of the 
stomach or acrid bile. Frequent sips of warm water will 
relieve it. 

Sick-Headache. — Acrid or putrescent bile in the stomach 
occasions this difficulty. It is generally attended with much 
nausea, and little or no vomiting, and more or less pain and 
dizziness of the head. Sijjs of warm water constitute the 
treatment. 

Salivation. — The pregnant woman sometimes drivels at the 
mouth, that is, excretes a sero-mucous fluid which is improperly 
termed salivation. It is not a discharge of saliva, but a mere 
excretion consequent on a morbid stomach. Let the diet be 
dry, solid, and simple. 

Sleepless?iess. — Preternatural wakefulness is among the occa- 
sional incidents of pregnancy. A hot-and-cold foot-bath at bed- 
time, and a cold wet cloth to the head will relieve. Let the 
woman avoid a late supper and all indigestible things. 

Pains in the breast, — The mammary glands sometimes 
become painful, either from inflammation or neuralgia. Cold 
wet cloths will relieve in the inflammatory cases. When the 
pains are of a neuralgic or spasmodic character, warm fomen- 
tations are appropriate. 

Pleuralgia. — Pain in the side, usually the right, sometimes 
becomes severe and persistent during the middle and latter 
periods of pregnancy, It is generally caused by congestion or 
enlargement of the liver. The wet-girdle and fomentations 
are the proper appliances. 

Difficult Breathing. — Constipated bowels, general plethora, 
or a swelling of the liver in the later stage of pregnancy, will 
occasion more or less difficulty of respiration, which sometimes 
becomes asthmatic and attended with cough. Abstemious 
diet, moderate exercise, and due attention to the bowels, are 
the remedial measures. 

Diarrhoea. — This affection is very uncommon with pregnant 

6 



82 The Mother s Hygienic Hand-book. 

women ; nevertheless it may occur. A horizontal and quiet 
posture, cool enemas, and the warm, wet girdle are the remedies. 

Misurination. — Inability to expel the urine is sometimes a 
very annoying difficulty. Warm and cold wet cloths applied 
to the lower part of the abdomen alternately, will usually relieve 
for the time being. 

Varicose Veins. — The veins of the lower extremities sometimes 
swell and present a knotty appearance, occasioned by the pres- 
sure of the pregnant uterus on the blood-vessels. No special 
treatment is required ; the bowels and skin must be kept free 
and the enlarged veins will disappear after parturition. 

Hysteria. — This is among the maladies attending pregnancy, 
according to authors, but I have never seen a case. Any pre- 
ternatural excitement may occasion it, and quiet is the remedy. 

Colic. — Griping pains in the bowels may be relieved by warm 
fomentations, or sips of warm water. 

Flatulence. — Whenever this is troublesome, draughts of warm 
water, toast water, apple tea, etc., will relieve. 

Jaundice. — This appearance indicates a temporary interrup- 
tion of the action of the liver. It will soon disappear if the 
bowels are kept free. 

Liver Spots. — Brown, dingy stains, frequently disfigure the 
cheeks and forehead. They are more annoying than dangerous. 
Brunettes are said to be more subject to them than blondes. 
They are caused by retention of bilious particles in the skin. 
They require no special attention except the avoidance of 
grease, sugar, butter, cheese, and all other "bilious" foods and 
condiments. 

Spitting of Blood. — Haemoptysis is among the occasional 
derangements of early pregnancy. It is seldom of importance 
unless the patient is consumptive. An enlarged or suddenly 
congested liver sometimes causes a slight hemorrhage from the 
lungs. Perfect quiet, sips of cold water, and warm applications 
to the feet, are the remedies. 

Palpitation. — Irregular action of the heart, amounting to 
painful throbbing or distressing palpitation, and frequently 



Diseases during Pregnancy. 83 

attended with giddiness, partial blindness, hot head and cold 
feet, is one of the most frequent disturbances of the pregnant 
state. There are many causes, all referable to unhygienic 
habits, and consequent morbid conditions. Green tea, coffee, 
the excessive use of butter, sugar, etc., and constipation of the 
bowels, are the general predisposing causes. The " attacks " 
are always traceable to some unusual derangement of the 
digestive organs, as acidity, flatulence, congested liver, over 
eating, late supper, or indigestible aliments. 

The remedy is preventive ; avoid the above causes. 

Disturbed Vision. — Partial or complete blindness may affect 
one or both eyes for a time. Sometimes black spots are 
imagined floating before the eyes as in amaurosis. The cause 
is in the digestive organs. Regulate the diet. 

Disturbed Hearing. — Partial or complete deafness may affect 
one or both ears temporarily. Buzzing in the ears is regarded 
as threatening convulsions. But I attach little importance to 
the symptoms. The cause is in the stomach or bowels. 

Paralysis. — Partial paralysis may affect the face, one side, 
or the lower extremities. The former cases are owing to in- 
digestion, and the latter to constipation — circumstances which 
sufficiently indicate the remedial plan. 

Convulsions. — These may occur at any period of pregnancy 
or during parturition. The remedial plan is simply removing 
all existing obstructions and avoiding all exciting causes. 
After the bowels have been moved by means of tepid enema, 
and fomentation applied to the abdomen for ten minutes, 
perfect rest is the remedy. 

Hemorrhage. — Bleeding from the uterus, termed " flooding/' 
during pregnancy, endangers miscarriage or abortion, and is 
usually attributable to a partial detachment of the placenta. 
Slight hemorrhages sometimes occur in consequence of mere 
congestion, and when these have happened periodically through 
the period of gestation, they have been mistaken for menstrua- 
tion. Quiet, and cold wet cloths to the abdomen, are all the 
remedies necessary. 



84 The Mother s Hygienic Hand-book. 

When the bleeding is profuse, vaginal injections of ice-water 
should be employed, followed by the tampon, or plugging the 
vagina. This means, introducing pieces of very fine sponge, 
a handkerchief, or better still, strips of cloth or a soft napkin, 
into the vagina, and pushing up as far as possible. By passing 
the tampon .up firmly against the os uteri, a coagulum will soon 
form and obstruct the bleeding vessels. The tampon should 
be changed every ten or fifteen minutes, and the patient kept 
perfectly quiet, in the horizontal position, with the hips raised 
a little above the level of the body. Fainting, which is apt to 
occur if the bleeding is profuse, always arrests the discharge 
for the time, and often permanently. 

Hemorrhage during labor requires precisely the same man- 
agement as far as it is practicable. This is usually owing to 
place?ital presentation — the placenta being attached over or so 
near to the os uteri that the contractions of the uterus in labor 
detach it more or less. When the bleeding is alarming, the 
remedy is speedy delivery, which requires the manipulations of 
the professional accoucheur. 

Hemorrhage, after delivery, requires a little different man- 
agement, and is always due to insufficient contraction of the 
uterus. The tampon must not be used here, for the reason that 
it would only dam up the blood in the uterus without removing 
the cause. The coldest water, or ice, should be applied to the 
abdomen ; the hand should be dipped in cold water and pressed 
firmly upon the abdomen so as to compress the uterus and 
excite contractile efforts ; and these may be also favored by 
gently kneading the abdomen and making passes downward 
from the umbilicus. In extreme cases cold water has been 
introduced into the vagina, and even uterus, with good effect. 

Dropsy. — Dropsical swellings of the lower extremities are 
common during the last two or three months of pregnancy. 
Sometimes the accumulation of fluid in the areolae tissue is so 
great as to occasion difficulty in walking. It usually commences 
at the feet and extends upward. As the trouble is caused by 
the pressure of the uterus on the adjacent parts, it disappears 



Diseases during Pregnancy. 85 

after childbirth. The circulation may be improved and the 
pain relieved by frictions and a horizontal position. The limbs 
should be raised on a chair or other support, and active friction 
made along the limbs from the feet upward, with the bare hand. 

False Waters. — Occasional discharges during pregnancy of a 
watery fluid, unattended with uterine contractions, have received 
this appellation — technically, hydrorrhea. These discharges 
may be tinged with blood, and mistaken for the " show " that 
indicates labor or abortion. The absence of the pains, or 
bearing down sensation is, however, sufficiently discriminating. 
All the treatment required is negative ; avoid all very active 
exercises, straining, lifting, running, dancing, etc. 

Lencorrhcea. — Those who are subject to a mucous or muco- 
purulent discharge from the vagina, known as " whites," will 
have an aggravation of the excretion during pregnancy. The 
disorder sometimes occurs in those women who have not been 
previously the subjects of it. In severe cases the discharge be- 
comes almost wholly purulent, of a yellowish-green color, like the 
sputa from ulcerated lungs, and attended with much itching or 
smarting. In these extreme cases small vesicles may appear 
on the internal surface of the labiae, which, opening, cause most 
distressing excoriation. 

The affected parts should be bathed several times a day with 
water of the temperature that is most agreeable to the patient, 
whether warm, tepid, cool, or cold. Vaginal injections should 
also be employed once or twice a day, but for this purpose the 
temperature of the water should be moderately warm, lest the 
shock occasion uterine contractions. 

Ulcerations. — Chronic ulcers of the womb, especially of the 
os uteri, are not uncommon, but do not materially affect the 
progress of gestation, nor of parturition, unless cancerous or 
malignant. Perfect cleanliness is all that need be cared for, 
until after childbirth, when the cure should be undertaken. 

Chro?iic I?iflammatio7i. — Acute inflammation seldom or never 
affects the pregnant uterus, but a disguised and chronic form 
sometimes occurs. It is characterized by a constant pain, 



86 The Mother s Hygienic Hand-book. 

tenderness, stitch, or sense of soreness ; the uterus is sensitive 
to pressure, and the pain is increased by walking, and, after 
quickening, by the movements of the foetus. The only serious 
difficulty to apprehend is, adhesion of the placenta. Cold or 
cool wet cloths to the abdomen, until the symptoms disappear, 
with careful attention to the bowels, are the specialties of 
the treatment required. 

Irritable Uterus. — This term is applied to the false pains that 
sometimes occur in the later period of gestation, caused by 
pressure and spasmodic muscular action. The pains more or 
less simulate true labor pains, but can readily be distinguished 
by placing the hand on the abdomen, and noticing that, during 
the false pains, the uterus does not contract into a hard tumor, 
as it always does in the case of true labor pains. Mental and 
bodily quiet, with sufficient rest in the horizontal position, will 
relieve. 

Vaginitis. — Chronic inflammation of the mucous membrane 
of the vagina is a very distressing though not dangerous com- 
plication. In extreme cases the inflamed part cannot bear the 
slightest touch without pain. Vaginal injections of tepid water, 
and hip-baths at 90 , once or twice a day, are the remedies. 

Mania. — Various forms and degrees of mental aberration, 
amounting to temporary delirium or insanity, are not uncommon 
during pregnancy. The patient may say and do very absurd 
and ridiculous things, manifest aversion to the persons and 
objects of her dearest affections, and conceive antipathies 
towards husband, children, or friends. It is important that 
this matter be understood by all parties concerned. We can 
indicate no special remedy, but whatever disturbing influence 
of body and mind can be ascertained, must be removed, lest a 
transient derangement be mistaken for a depravity or a pre- 
cursor of permanent mental hallucination, or dementation. 
Quiet, the removal of all disturbing persons or influences, 
warm foot-baths, and cold applications to the head, are the 
remedial measures. 

Magnetic manipulations are applicable to these cases. 



Diseases during Pregnancy. 87 

Those who are skilful in mesmeric manipulations can often 
restore those distressed patients to their mental balance at 
once, and sometimes unskilful operators succeed. The proper 
" passes " are made by passing the hands very gently over the 
patient's eyes in a downward direction. The passes are also 
applicable to sleeplessness, and to that indefinable state of rest- 
lessness and perturbation generally termed "nervousness." 



88 The Mother s Hygienic Hand-deck. 



CHAPTER XII. 

Management of Labor. 

Having determined the fact that the woman is really in 
labor, and ascertained the kind of presentation (unless delivery 
is near completion), the physician, if a man-midwife, should 
retire from the room for a short time in order to relieve the 
patient from embarrassment. When he resumes his position 
as attendant he should never fail, if the case be a first one — 
primipara, — to instruct her in relation to the breaking, rupture, 
or " bursting " of the " bag of waters," as the information may 
save her from an injurious shock. Or if he finds the labor far 
advanced, the " bag of waters " protruding and liable to rupture 
at any moment, he should not fail to explain what is about to 
occur. 

The membranes are usually ruptured at the point correspond- 
ing to and in front of the presenting part of the child. In this 
case the waters are discharged at once, and the presenting 
part " engages " or comes in direct contact with the os uteri. 
But they may rupture elsewhere, and the waters be discharged 
more or less with each subsequent contraction of the uterus. 
Whenever the membranes protrude through the os uteri into 
the vagina so that the waters present a tumor, one half or more 
the normal size of the child's head, they should be ruptured at 
once, as this procedure will save the patient several unnecessary 
pains, and, perhaps, prevent the child coming into the world 
with a " vail " over its face, and body. 

Attendants. — No one should be allowed in the room except 
" on business." The presence of all idlers and curiosity-seekers 
cannot be otherwise than mischievous. Besides the husband, 
nurse, and professional attendant, some lady friend is all the 
company desirable or that can be in any manner useful. No 



Management of Labor. 89 

conversation should be introduced or allowed concerning hard 
labor, accidents,, or extraordinary occurrences of any kind. 
Indeed, the conversation should take almost any direction 
save that pertaining to the business in hand. Above all things 
avoid whispering, also any word or deed that seems in the least 
mysterious or secretive. Whatever is not proper to say frankly 
and openly should not be said at all. 

In lingering labors, especially in first cases, husband, nurse, 
and all persons present, are very apt to become needlessly 
alarmed, or in some way disconcerted, and their disquietude is 
almost certain to be communicated to the patient, aggravating 
her pains, intensifying her fears, and still further prolonging 
her efforts. Perfect self-possession under all circumstances is 
like a " merry heart which doeth good like a medicine." It is 
a medicine, and "strictly Hygienic." 

Dress. — As soon as the labor pains become decidedly bearing- 
down, and before the second stage of labor has fairly com- 
menced, the dress of the patient should be so arranged as to 
prevent its being stained or soiled. The chemise is usually 
folded up around the waist, and the bandage to be fastened 
around the abdomen after delivery pinned around it. But as 
Hygienists do not employ the bandage, this part of the prepara- 
tion may be omitted. Below the chemise a small folded 
sheet or a flannel skirt may be put to protect the clothing above. 

Position during Labor. — Much speculation has been indulged 
in and many observations made respecting the normal position 
of the woman during the delivery of the child. When women 
have been left entirely to themselves some have taken one 
position and some another. Some have chosen the bed, others 
a squatting position, others resting on the hands and knees on 
the floor, wmile some have changed from one of these positions 
to the others frequently, and been delivered finally in either one 
as it happened. 

There is little to chose between the chair or stool and the 
bed, except that the latter position is more convenient for the 
patients after-delivery, and more agreeable to the attendants 



90 The Mother s Hygienic Hand-book. 

and practitioner. The bed is now preferred by physicians 
generally, as being quite as well for the patient, all things 
considered, and altogether most convenient for all others con- 
cerned. 

Some accoucheurs have a preference for the left side, direct- 
ing the patient to lie on her left side near the edge of the bed. 
I am not aware of any advantage of this position over that on 
the right side, so far as the patient is concerned ; but as most 
physicians are more accustomed to employ the right hand than 
the left in obstetrical manipulations, it may be a great accom- 
modation to them — provided there should be any thing for 
them to do save "watch and wait." 

Regulating the Pains. — During almost any stage of labor the 
uterine contractions may become feeble, irregular, or be 
altogether suspended. Exciting news, any mental shock, or 
the arrival of a strange physician may cause their suspension 
for a time, in some cases followed by vomiting, cramps, or 
sharp pains in the muscles of the back, abdomen, or lower 
extremities. 

If the patient is able to walk around the room a few minutes, 
the pains, if suspended, will generally return, and if irregular, 
will soon become regular. In most cases gentle frictions over 
the abdomen will succeed. Compressing the uterus gently 
through the abdominal walls will also aid in restoring normal 
uterine contractions. 

It is customary in these cases to administer ergot, myrrh, or 
other " forcing " medicines ; but they endanger the life of the 
child and render the mother liable to hemorrhage, hour-glass 
contraction, and other distressing sequelae. 

Birth of the child. — During the first stage of labor, as we 
have seen, the os itteri becomes sufficiently dilated for the 
child's head (or other presenting part) to press down strongly 
on the soft parts of the mother — the vagina and perineum. 
The patient will now feel a strong inclination to co-operate with 
the expulsive efforts of the uterus, that is, make bearing-down 
efforts. She should be encouraged to do this, as a little mental 



Management of Labor. 91 

effort on her part may co-ordinate and harmonize the action of 
the respiratory, abdominal and uterine muscles, rendering the 
progress greater and the suffering much less. She should be 
instructed to take a full inspiration, then when the lungs are 
fully inflated, hold the breath as long as convenient, and bear 
down steadily as long as possible. If she will shut her mouth 
firmly and restrain from all exclamations during the pains, 
continuing the downward effort with all her strength, she will 
gain time and lessen the distress. 

During these vigorous bearing-down efforts she is apt to 
complain of severe pain in the small of the back. This maybe 
greatly alleviated by pressing against it moderately with the 
hand. 

It happens frequently, especially in first cases, as the delivery 
approaches its termination, and while the pains in the back are 
considerable, that the patient becomes excited, perhaps hysteri- 
cal, talks incoherently, and seems distracted with vague 
apprehensions. She should be quieted with the assurance that 
her troubles will soon be ended, urged to keep her position on 
the bed as steadily as possible, and continue her bearing-down 
exertions. 

At this time a pillow should be folded and placed between 
her knees, and her feet allowed to press against the foot-board, 
or something equivalent. Also fasten a folded sheet, towels, 
or something similar, to the bed post, and let her pull against 
it while bearing-down, as firmly as she inclines to. 

Supporting the Perineum. — As the head is being delivered, 
obstetrical authors regard it as very important to " support 
the perineum." The object of this is to prevent rupture or 
laceration of the soft parts at the moment when the largest 
diameter of the child's head passes. And supporting the 
perineum means pressing steadily against it. I regard this 
proceeding as worse than useless. It is utterly impossible, on 
account of the exertions, and often severe struggles of the patient, 
to make steady pressure, and if it could be clone the result 
would only endanger the very accident it is intended to prevent. 



92 The Mother s Hygienic Hand-book. 

I have never practiced this method of "support," and have 
always advised my students against it ; and I have never 
known a rupture to occur in my practice or theirs. 

It seems to me a self-evident fact in mechanics that pressure 
on both sides of the soft parts would be more apt to injure them 
than pressure on only one side. As the child's head 
emerges from the soft parts, they are stretched almost as thin as 
parchment \ but being musculo-membranous in structure and 
exceedingly elastic, lacerations are very rare. If, however, 
severe pressure is made on one side by the passage of the 
child's head, and on the other by the hand of the attendant, 
the chances of rupture are just doubled. If pressure is made 
at all it should be against the child's head to render its 
progress slower, and give more time for the soft parts to dilate ; 
but even this can amount to but little. 

Subsidence of the Pains. — It sometimes happens that the 
uterine efforts become very weak or entirely subside when the 
delivery is almost completed. This is never an alarming 
occurrence in normal labor. It means that the muscles con- 
cerned in expulsion have become fatigued and need rest. Let 
them rest. If there are no complications they will resume 
work in due time. Some obstetricians recommend hot tea, 
brandy, volatile alkali, &c, to reproduce the pains ; but rest is 
the better remedy ; besides, stimulants endanger hemorrhage 
when there is a predisposition to it. If the practitioner 
cannot well wait till nature is recuperated by rest, he may 
hasten the resumption of expulsive efforts, in the safest manner 
possible, by abdominal manipulations with the bare hand. He 
may gently compress the uterus through the abdominal walls : 
move the hand, making moderate pressure, from the umbilicus 
downward, patting the abdominal muscles very gently from 
above downward, &c. 

Duration of the Second Stage. — The second stage of labor is 
exceedingly variable in duration. The child may be expelled 
by a single prolonged pain, or by ten or twenty. The average 
is perhaps a dozen or thereabouts. But if the presentation is 



Management of Labor. 93 

normal, no woman need fear a successful issue, however severe 
or prolonged the pains may be. 

There are cases in which, because of a large head, or a 
rigid and narrow outlet, or both, an hour, or several hours of 
vigorous uterine contractions are required to mould and shape 
the head so that it can pass. It is wonderful to notice the 
extent to which the head can be pressed out of shape without 
injury, because of the elastic bones and sutures of the skull. 
I have known cases in which the head was so elongated and 
the features so distorted as to suggest the idea of monstrosity 
or deformity, yet in a few hours thereafter the baby was as 
good-looking as the fond mother supposed any baby possibly 
could be. 

Receiving the Child. — As the head of the child is expelled, it 
should be supported in the palm of one hand — the right hand 
when the patient is on the left side, but be very careful not to 
do any thing else. Avoid all pulling or traction. See that the 
cord is not coiled around the neck of the child, so as to 
endanger suffocation, or is not drawn so tight as to endanger a 
rupture at the navel. In the former case it can be uncoiled in 
a moment unless too short, when it must be loosed a little by 
pulling it down, and the labor hastened by abdominal manipu- 
lations. This is also the method of proceeding when the cord 
strains upon the navel. 

If the child is retained in this position more than half a 
minute, examine and see if its face is blue and bloated. If 
this is the fact, the circulation of the cord is interrupted by 
pressure, and the delivery must be hastened by means of 
abdominal manipulations, and by making gentle traction with 
the index finger placed under the armpit of the child. 

The first thing to ascertain after the child is born, is whether 
it breathes. If the lungs readily and fully expand, a lusty 
squall that always delights the hearts of mothers and midwives, 
will proclaim the advent of the little stranger into this breath- 
ing world. If this notice of appearance does not occur, see 
that the mouth is not obstructed with mucus, nor impinged 



94 The Mother s Hygienic Hand-book. 

against the bedding; always turn the face of the child from the 
mother, so that its respiration will not be affected by the 
discharges. 

Cutting the Cord. — -The cord should be cut as soon as its 
pulsation has ceased. This usually happens in a minute or two 
after birth, sometimes in a few seconds. Tie a string around 
it about an inch and a half from the navel, and place another 
ligature as far from that, cutting between them with scissors. 
The end of the cord attached to the child is then to be 
wrapped in a soft rag, a soft napkin placed around it, and the 
child put in soft blankets, and placed in a safe position — ■ 
never in the rocking chair. 

The After-birth. — After the birth of the child, the patient 
remains free from pain for a time, varying from a few minutes 
to several hours. The usual time is ten to thirty minutes, 
when the uterine contractions, with more or less pain, are 
resumed, and the after-birth expelled. It frequently happens 
that the after-birth is expelled into the vagina with the con- 
traction of the uterus that completes the delivery of the 
child. This fact may easily be ascertained, and always should 
be. Grasp the lower part of the abdomen firmly with the hand, 
and if you feel a firm hard ball or globular tumor, you may be 
assured that the uterus is firmly contracted, and empty, — that 
the after-birth is expelled. If the abdomen is but slightly 
collapsed, and no round tumor distinguishable through its 
walls, the after-birth is still within its cavity, unless there is a 
twin-baby, which fact will soon be disclosed by a renewal of 
the bearing-down efforts of the uterus. 

When the abdomen is sunken, denoting a partial contraction 
of the uterus, but not to the extent of expelling the after-birth, 
wait until the uterus begins to contract, which will be indicated 
by slight pains, or more or less distinct bearing-down efforts, 
or both. If these efforts are feeble, they may be assisted by 
gently pulling on the cord, and manipulating the abdomen from 
above downward, or still more efficiently by dipping the hand 
in cold water, and gently compressing the abdomen with the 



Management of Labor. 95 

open hand and fingers. One, two, or three uterine contractions 
are usually sufficient. 

When the after-birth is expelled from the uterus, it may 
remain indefinitely in the vaginal canal without exciting any 
noticeable pains or contractile efforts of any kind. I have 
known young practitioners wait impatiently for hours for the 
uterus to do something, when there was nothing for it to do. 
The placenta and membranes were all in the vaginal passage, 
and only required to be taken away. This may always be. 
properly and safely done, when the uterus is fully contracted, 
as already explained. 

But even this very simple operation may be performed very 
awkwardly, or not at all, by a very little mismanagement. In 
making traction on the cord, some persons forget, and others 
do not know, that the force should always be made in the line 
of the pelvic channel. If the cord is pulled too much forward 
against the pubic bones, it may break without moving the 
after-birth in the least, and I have known this very annoying 
accident to happen in this way more than once. The cord 
should always be pulled downward and backward as much as 
possible. The better management is to pass two fingers along 
the cord to the after-birth, letting the cord guide the fingers by 
resting in the depression between them \ then press downward 
and a little backward while pulling the cord directly forward. 
The fingers serve as a sort of pulley to move the after-birth 
along the centre of the passage, I have several times removed 
the after-birth in this manner, in less than one minute, after 
hours had been expended in misdirected efforts. As a last 
resort, when necessary, the hand can be introduced, the fingers 
formed into a conical shape, into the vagina, until they come 
in contact with the placenta, which will feel like a spongy 
mass. The fingers and thumb can then readily grasp, or link 
into, some portion of the mass, and easily remove it. This is 
always the way to manage when the cord is broken. 

Obstetricians usually envelop the cord in a linen cloth, and 
twist it two or three times around two or three fingers of one 



96 The Mother s Hygienic Hand-book. 

hand, while the other is introduced, in cases where the placenta 
is retained, and the cord unbroken. But if a knot is tied in 
the cord, one or two twists around the index finger, without 
any linen, will answer all purposes. 

It should be recollected that the after-birth includes the 
placenta and membranes. For this reason, when the after-birth 
passes through the vagina, it should be twisted around two or 
three times — rotated on itself — so as to wind the membranes 
into a cord, and prevent the contraction of the os uteri from 
retaining any fragments. 

Coagida. — In cases attended with considerable hemorrhage, 
it sometimes happens that coagulated blood will lodge in the 
os uteri, and occasion distressing bearing-down pains. Con- 
vulsions have been attributed to this cause. Should any 
untoward symptom indicate this condition, the fact can be 
easily ascertained, and the coagula may be readily removed 
with the finger. 

Chloroform. 

The propriety of using chloroform during labor, and the 
cases to which it is adapted, ought to be understood by pro- 
fessional nurses as well as regular physicians ; hence a few 
words on the subject may be a fitting conclusion to this chapter. 
There is much discrepancy in the medical profession respecting 
the cases in which it may be properly employed, some pre- 
scribing it as a general rule, and others in rarely exceptional 
cases. It is certain that the effect of chloroform is injurious to 
both mother and child. It must, therefore, always be regarded 
as a choice of evils, and its use limited to preternatural 
labors and extraordinary complications. In malpresentations 
which require version, or turning, and in all operations during 
labor which require the tedious, painful, or prolonged use of 
instruments, and in the terrible agonies that sometimes result 
from extreme rigidity or inflammatory conditions, chloroform 
is not only justifiable, but proper. 

There is no danger to be apprehended if it is skilfully man- 



Management of Labor. 97 

aged. It should always be inhaled very slowly, well mixed 
with atmospheric air, and the room thoroughly ventilated. ]t 
is not always necessary to procure mental unconsciousness in 
order to alleviate pain. A partial anaesthesia is usually suffi- 
cient, except in the cases of severe operations. 

A mixture of equal parts of ether and chloroform is pre- 
ferable to pure chloroform, and probably the very best, mildest, 
and most manageable preparation for anaesthetic purposes, is 
a mixture of one part alcohol, two of sulphuric ether, and three 
of chloroform. 

7 



y8 The Mothers Hygienic Hand-book. 



CHAPTER XIII. 

Attentions to the Child. 

As we have already explained, when the child is sufficiently 
noisy, we have no further trouble on its account except to dress 
it and feed it. 

But viable children are sometimes born in an unbreathing 
condition. They appear as still-births, yet may be saved. For 
some reason the respiratory muscles remain dormant. Many 
causes may induce this condition, as prolonged pressure on the 
cord, extreme compression of the brain, &c. It has been 
caused by ergot, belladonna, and other narcotics administered 
to the mother, or applied to the os uteri. Chloroform has 
occasioned it. 

If the child does not breath, clear the mouth of mucus, if 
obstructed with it, by wiping it out with a soft handkerchief 
wrapped around a finger ; next sprinkle the face, chest, and 
back with cold water ; and if the child does not show signs of 
vitality, alternate the sprinkling with warm and cold water ; 
patting the child rather smartly, with the hand dipped in cold 
water, on the back and abdomen, will sometimes instantly 
produce the respiratoiy efforts. All of these efforts may be 
aided by pressing on the abdomen with the flat hand for two 
or three seconds, then removing the hand suddenly, and thus 
alternating, so as to imitate in some degree the motions of the 
abdominal muscles, and diaphragm in the act of respiration. 

A stream of cold water falling from a height of several feet 
on the chest or back has succeeded in some instances, as has 
also a current of electricity passed to the chest from the nape 
of the neck. Powerful shocks should always be avoided. 

During these or any other attempts to excite respiration, the 
head should not be allowed to fall forward on the chest, the 



Attentions to the Child. 99 

body of the child should be kept straight on a level surface, 
and the head should always be lower than the body. 

Half an hour is not too long to persevere in these manipula- 
tions if respiration is not sooner produced. Cases are well 
authenticated in which much more^ prolonged efforts have been 
successful. 

Dressing the Child. — Neither soap nor grease should be 
applied to the delicate skin of a new-born child. A fine 
sponge or soft flannel cloth and moderately warm water are 
all that are useful or necessary to remove the viscid matter 
that adheres with more or less tenacity to the surface. Mothers 
and nurses are apt to overdo the washing and rubbing business, 
from sheer fastidiousness, or a desire to have the whole surface 
of the little thing shine like polished marble. They may be 
assured that that adhesive matter they are so anxious to scrape 
off, if need be, is one of the most harmless things imaginable, 
and all that is not removable quickly by gentle means may safely 
be left to the " efforts of nature." They should recollect, too, 
that the skin of the child, on its access to atmospheric air, is 
extremely sensitive, and if it do not cry nor complain, it is no 
less liable to injury. The washing operation should always be 
performed quickly, and the skin wiped dry with a warm soft 
cloth to prevent chilliness. Some persons apply nor only soap 
to the skin of the baby on the occasion of its first ablution, but 
even add diluted alcohol, or some form of ardent spirits. This 
is more than barbarous. 

To prevent the umbilical cord from chafing the skin, as well 
as to keep it in place, it may be drawn through a hole made in 
the centre of an old linen rag a few inches square, which 
should be oiled or smeared with mutton suet, or simple cerate, 
and folded around it, covering the whole with a fine flannel 
cloth around the abdomen. The folded cord should always ba 
turned upward on the abdomen. 

The " belly-band " so generally employed by all other 
practitioners is dispensed with by all Hygienic physicians. It 
is worse than useless. The young child does not need to have 



ioo The Mother s Hygienic Hand-book. 

its little abdomen " supported " or cramped by a bandage 
pinned tightly around it, more than does the young lamb or the 
new-born kitten. Nature has made the best arrangements, 
and all interference is simply pernicious. The child wants all 
possible freedom of motion, while the " belly-band " not only 
prevents free breathing, but injures the abdominal and 
thoracic viscera by compression. 

In the matter of the child's clothing, the essential points are, 
to have the diaper thin, fine, and soft, and to have all the 
garments loose, and equibly distributed over the body and 
limbs. Low neck dresses, with short sleeves, and an excess of 
clothing on the chest, and especially the abdomen, are the 
common errors in the dresses of children and babies, and the 
common causes of their frequent coughs, colds, croups, and 
premature deaths. 

Feedi?ig the Baby. — In a few hours after the birth of the 
child, and as soon as the mother is well rested and the child 
properly dressed, the child should be allowed to take its first 
meal, which should always be breast-milk, and nothing else, 
when this can be had. No harm will result if the food is not 
quite ready when the little stranger is invited to the feast. Its 
efforts to partake will accelerate the production. 

One of the abominable customs of physicians and nurses 
who profess to be civilized is, to feed the infant with sweetened 
urine, or some worse laxative medicine, to purge away the 
meconium, as the dark slimy matter which first passes from the 
bowels is termed. Something or somebody has taught them 
that this meconium is a dreadful matter to have in the bowels, 
and should be physicked out with all possible dispatch. Its 
presence in the bowels for a week would be much less injurious 
than a single dose of the medicine usually administered to 
•remove it ; moreover, the mother's first flow of milk is exactly 
the "medicine" required. 

Three or four times a day is enough to nurse the infant, and 
not at all during the night. Feeding the infant once or twice, 
or whenever it cries or gets uneasy during the night, is a most 



Attentions to the Child. 101 

pernicious practice, and leads to the habit eventually of eating 
as the remedy for all bad feelings. Begin with the baby right, 
and it will soon learn to sleep at night and eat during the day. 

When the mother's milk is deficient or absent, cow's milk is 
the best substitute. It may or may not be diluted with a little 
pure water, according to its richness. If the cow, in the 
winter season, is fed almost wholly on hay, and not slopped 
with anything, the milk should be diluted with one part pure 
water to two or three of milk. In the summer time, when 
fresh grass is the principal food, no dilution is required. 

It is another common and pernicious custom to sweeten 
cow's milk, when fed to babies, with loaf sugar. This induces 
constipation invariably, and all its train of colics, gripings, 
flatulence, humors, &c. 

Great care should be taken to have the infant, when obliged 
to feed from a bottle, to take its food slowly, and drop by drop, 
as it does from the mother's breast. Fast eating is as bad for 
infants as for adults. 



102 The Mothers Hygienic Hand-book* 



CHAPTER XIV. 

Attentions to the Mother. 

Although some mothers are able to wait on themselves 
immediately after delivery, and even wash, dress and take full 
charge of the child, the majority are quite otherwise. The safe 
rule, therefore, is for the woman to see how little she can do rather 
than how much. There would be little danger of any serious 
consequences if she should exert herself all she had ability to, 
provided she was in perfect health, full vigor, and of normal 
habits in all respects. But this is the case with few, and, 
unfortunately, what is termed " high civilization " is almost 
everywhere associated with unhygienic habits and consequent 
liability to disease. Any considerable exertion, before she is 
well rested, may endanger hemorrhage, or occasion uterine 
displacement. Hence the safe rule is not to allow the woman 
to help herself at all at first. 

The soiled garments and clothing should be removed without 
any exertion on her part, and a soft napkin applied to the vulva. 
She should not be exposed to a draught of cold air, and if 
inclined to chilliness she should be kept very quiet and well 
covered with blankets until the external circulation is fully 
restored. 

The " bandage " which is generally pinned around the 
abdomen had better be omitted. The same objections in kind 
apply to the " abdominal bandage " of the mother, as to the 
"belly-band" of the child, though not in degree. Both 
however, are worse than useless. The object of the bandage 
is to bring the abdomen into proper shape again ; but this, 
nature has fully provided for in the contractile structure of the 
uterus, and abdominal walls and muscles. If this bandage is 



Attentions to the Mother. 103 

applied very tightly, it must tend to produce prolapsus ; if not, 
it can be of no possible service. 

After the woman has rested for a few hours there is little 
danger of flooding, displacement, excessive after-pains, or rush 
of blood to the head, or any other accident, by any reasonable 
exertion thereafter. I have known cases in which fainting and 
severe determination to the brain resulted from the rashly 
heroic attempt of the woman to take a hip-bath a few minutes 
after delivery. A few might do this safely, but the experiment 
is as needless as rash; wet cloths and vaginal injections are a 
perfect substitute for a hip-bath in all cases where this is 
supposed to be indicated. 

Company. — The friends and relatives of the mother should 
not be allowed to intrude upon her, not even to tender 
congratulations, until she has had sufficient rest. The addi- 
tional excitement which their presence would occasion might be 
the cause of flooding, when there is a predisposition to it, or of a 
feverishness which would interfere with the due secretion of 
milk. 

Regimen, — Wine, cordials, broths, hot teas, and slop dishes 
of every kind are objectionable immediately after delivery. 
Nothing should be taken into the stomach until the woman is 
well rested, except pure water according to the thirst. If she is 
inclined to chilliness, a little warm water may be taken. When- 
ever she feels in good condition and appetite returns, she may 
partake of a simple meal, and it can hardly be too simple. 
Mothers ought to understand that the quality of the first milk 
they furnish for the subsistence of the offspring is better or 
worse as their dietetic habits are proper or otherwise. The 
alcoholic stimulants that are so generally prescribed have a 
most deleterious effect on the child, as do all high-seasoned and 
complicated dishes. The child may be rendered sickly, or its 
life destroyed, by such a dietary on the part of the mother as 
will not seriously disturb her. 

Passional influences, — It is just as important that the mind of 
the mother should be maintained in a composed and agreeable 



104 The Mothers Hygienic Hand-book. 

condition, in order to have the milk of proper quality, as it is 
to have the food and drink wholesome. Anger, grief, or any 
violent passion or depressing emotion, will instantly affect the 
quality of the milk injuriously. Soon after delivery the whole 
organization of the mother, bodily and mental, is in a 
peculiarly impressible condition, and influences which at other 
times would seem to do no serious damage, might produce 
disastrous consequences to either mother or child. 

All obstetricians of much experience know how readily the 
mother's milk is rendered unwholesome and even poisonous to 
the nursing infant because of some violent mental commotion 
on the part of the mother. To understand the principle 
involved we need only refer to convulsions, diarrhoea, paralysis, 
&c, which are not unfrequently caused in adults by mental 
shock, fear, despondency, &c. 

I have no doubt that thousands of drunkards and debauchees 
owe their early propensity to dissipation to the " few drops of 
brandy " which were administered to the child the first days of 
its existence, or to the mother during the nursing period. 

It is a melancholy fact that nearly all the " soothing syrups " 
and other medicaments for children that fill the newspapers 
and deluge the land, are the vilest compounds of alcohol, 
opium, and other stimulants and narcotics. 



Disorders Incident to Labor. 105 



CHAPTER XV. 

Disorders incident to labor. 

Rigidity. — In some cases, especially in the first labors of 
strong young women, the abdominal walls may be so firm and 
unyielding as to cause injurious pressure on the abdominal 
viscera* The wet-girdle worn a part of each day, and the hip- 
bath for ten minutes at 90 once or twice a day, will remedy 
this difficulty. 

During labor, the vagina, os uteri, or external parts, may be 
so rigid as greatly to retard progress and aggravate the 
sufferings of the patient. In such cases, warm water should 
be applied. If the labor is not too far advanced, a more 
effectual remedy may be found in steam or vapor, over which 
the patient may sit. For this purpose hot water can be poured 
occasionally into a pail or small tub ; or the vapor can be readily 
extemporized by putting a hot brick or stone into the water. 

The narcotic washes and ointments that are so generally 
employed in these cases, are much less efficient agents in 
inducing relaxation than is the vapor of water, besides being 
positively injurious to the child, and possibly causing hemorr- 
hage by occasioning atony or paralysis of the uterine fibres. 

Retained Placenta** — -This may be caused by abnormal ad- 
hesion to the uterus — the consequence of pressure or inflam- 
mation — by atony of the uterus, hour-glass contraction, or by- 
morbid enlargement of the placenta itself. Some authors add 
to the causes, spasm of the os uteri. 

When the placenta is partially detached from its connection 
with the uterus, there is usually considerable hemorrhage ; and 
the management should be prompt and decided in proportion 
to the loss of blood. In the absence of flooding the case may 



io6 The Mothers Hygienic Hand-book. 

be safely left to nature, with such measures to induce uterine 
contraction as have already been mentioned. 

Obstetricians have discussed the question, how long should 
we wait, when there are no complications demanding prompt 
delivery, before suspecting morbid adhesions, and attempting 
the extraction of the after-birth ? Although opinions differ on 
this as on almost all medical subjects, the majority limit the 
time to two hours. 

The measures already recommended to excite uterine con- 
traction are applicable here, but may require to be employed 
with more vigor and persistency. If they do not succeed, or 
if hemorrhage, convulsions, or any other alarming complication 
attends, the hand should be at once introduced, in a conical 
form, into the uterus, and the placenta detached by gradually 
tearing it away with the fingers, the uterus, meanwhile, being 
steadied by the other hand pressing firmly on the lower part of 
the abdomen. 

When retention is caused by atony, or weakness of the 
uterine muscles, the manipulations already mentioned will be 
sufficient. The electrical current is also useful, if skilfully 
applied. 

Hour-glass contraction is a spasmodic contraction of the 
upper portion of the neck, or in the body of the uterus, con- 
stricting its middle portion, and dividing the organ into two 
compartments resembling an hour-glass in shape, and retaining 
the after-birth in the upper compartment. The agony resulting 
from this condition is often extreme. Two measures may be 
employed to overcome the spasm : warm fomentations to relax 
the muscular fibres of the strictured part, and manipulations to 
restore the action of the longitudinal fibres of the body of the 
organ. These measures should be employed in rapid alterna- 
tion. Flannel cloths dipped in water as hot as can be borne, 
wrung so as not to drip, should be applied to the abdomen for 
one or two minutes, and then the hand, dipped in cold water, 
should rub and knead the abdomen one minute. It will assist 
to introduce a piece of prepared jsponge, enveloped in soft 



Disorders Incident to Labor. 107 

linen, or some other convenient substance, into the cavity of 
the uterus, to act as a wedge (its apex being against the 
stricture), but this is rarely necessary. 

Morbid enlargement, or excessive size of the after-birth, is not 
a common complication, nor is it difficult to manage when it 
does exist. Whenever, after delivery, the uterus contracts 
vigorously without the after-birth coming away, morbid adhesive 
enlargement, or some other impediment may be suspected. 
The after-birth may be retained in consequence of being 
doubled upon itself, as well as ^because of excessive size. The 
after-birth in either of these cases can be readily detected by 
the touch through the os uteri, and the remedy in both cases, is 
to introduce the hand, and bring it away. The rule for pro- 
ceeding is invariably to introduce the hand in the absence of 
uterine contraction, and bring the mass away while the uterus 
is contracting. Otherwise flooding, or inversion of the organ, 
would be endangered. 

In some cases the after-birth is retained by an accumulation 
of coagula, and in others, by the liquor amnii pressing down 
against it, so as to form a kind of sac over the os uteri. When 
coagula exist, they should be removed at once. When the sac 
is present it should be ruptured, which will end the difficulty. 

Spasm of the os uteri sometimes occurs soon after delivery 
of the child, so as to render the introduction of the finger 
difficult, and prevent the expulsion of the after-birth. In these 
cases, the woman may suffer intensely from the fruitless 
efforts of the uterus to expel its contents. Warm water is the 
remedy. Warm wet cloths (soft linen) may be applied to the 
os uteri, and fomentations to the abdomen. Vaginal injections 
of warm water are still more efficient, when it is convenient to 
apply them. Some authors recommend inserting one finger 
into the os uteri, and allowing it to remain some time. This 
may be followed by a second, and, finally, a third finger, if 
need be. 

Inversion. — When the uterus is turned inside out, it is said to 
be inverted. This usually occurs, if at all, immediately after the 



io8 The Mothers Hygienic Hand-book. 

delivery of the after-birth, or with it. Fortunately, this 
accident is very rare. 

The common causes of inversion are : attachment of the 
placenta to the upper part of the uterus, too forcible pulling 
of the cord, or violent exertion on the part of the patient. In 
a few cases recorded, the inversion seems to have been 
attributable to congestion and weakness of the uterus. 

When the uterus is completely inverted, nearly the whole 
organ is external to the vagina, presenting a tumor whose base 
is below, and apex above. The^os uteri, of course, cannot be 
recognized. It may be distinguished from a polypus tumor by 
this having its base above, and its pellicle or apex below. 
Inversion is generally attended with much flooding. 

In all cases the organ should be replaced with all possible 
expedition ; yet this is one of the cases in which the attendant 
should never lose time by being in a hurry. If the placenta be 
still attached, and can be peeled off readily without much 
force, this should be done • if not, both uterus and placenta 
should be returned into the pelvic cavity, and the placenta 
thereafter removed as in ordinary cases of adhesion. 

The manner of procedure is as follows, and no intelligent 
nurse need fail in the operation if obliged to undertake it : 
Grasp the tumor by the hand and press it steadily and firmly, 
pushing its most prominent lower portion into itself, so as to 
re-invert it. If the uterus contracts, which will be known by 
its becoming suddenly hard and tense, cease all efforts at 
reposition until it relaxes ; then renew the pressure, pushing 
the hand, formed into a conical shape, into the depression, and 
so on until the organ is restored to its normal position. 

Hemorrhage. — In addition to what has been said in a pre- 
ceding chapter on this subject, it may be remarked in this 
place, that hemorrhage after delivery is among the most 
alarming occurrences for which the practitioner should always 
be provided. In normal labors very little blood is lost, — pro- 
bably none. Indeed, I am of the opinion that all hemorrhage, 
during either menstruation or parturition, is abnormal. I can 



Disorders Incident to Labor. 109 

understand why blood should flow when a tooth is pulled, a 
tumor excised, a limb amputated, or a blood vessel ruptured. 
But none of these cases are analogous to menstruation and 
parturition, which are normal processes. And the facts that 
undomesticated animals lose no blood in the performance of 
these functions, and that some women do not, is conclusive 
with me that all uterine hemorrhage is pathological, and the 
consequence of disease and debility. 

It is important to distinguish between external and Jntemal 
hemorrhage. In the former case the blood passes from the 
uterus into and through the vagina. In the latter case it is 
retained in the cavity of the uterus. The former is readily 
known by the sanguineous discharge. The latter is manifested 
by the fulness of the abdomen, the pallor of the face, and, in 
extreme cases, the ghastly cheek, and the speechless and uncon- 
scious condition of the patient. 

There is a single indication of cure in all cases — induce 
utcri7ie contraction. Here, I repeat, the tampon must never be 
used ; it is always dangerous, and may, by converting an exter- 
nal into an internal bleeding, prove fatal. Abdominal manipu- 
lations, the application of cold water, which may be dashed 
with some force or poured from a height on the abdomen, and 
the introduction of ice into the vagina, are the main remedies 
to rely upon. When the placenta is still attached, and the 
hemorrhage is not immediately arrested, the hand should be 
introduced into the uterus and the placenta removed. The 
patient may also take frequent sips of ice water. In extreme 
cases, the injection of cold water into the cavity of the uterus 
has excited uterine contractions and arrested the hemorrhage 
at once. 

Should the extremities become cold, they must be promptly 
warmed with bottles of hot water, or warm flannels, and the 
patient should be kept perfectly quiet ; any sudden exertion, as 
sitting up, might be instantly fatal. 

Brain Fever. — When blood is rapidly lost in flooding, the 
patient will f. equently faint, and the hemorrhage be moment- 



iio The Mothers Hygienic Hand-book. 

arily arrested ; but when the blood runs away slowly and 
uninterruptedly, and in all cases where a large quantity has been 
lost, and perhaps several hours after the bleeding has ceased, 
the patient may have a determination of blood to the brain, 
accompanied with intense headache and extreme intolerance to 
light ; the face will be flushed, the temporal arteries will throb, 
and the brain symptoms will closely simulate inflammation of 
the brain. Indeed, this erroneous diagnosis has often been 
made, and the patient bled for a malady caused by the loss of 
blood. Perfect quiet, cold applications to the head, and warm 
ones to the feet, are the remedial measures. 

Convulsions. — When convulsions occur during labor, they 
may generally be relieved by the measures mentioned in a 
preceding chapter ; but if not, the labor must be hastened by 
all the appliances adapted to the circumstances of each par- 
ticular case, as explained in other parts of this work ; they are 
often traceable to some local irritation, as constipation, con- 
gestion of the brain, engorgement of the liver, etc. ; hence an 
enema, cold applications to the head, or fomentations over the 
region of the liver, are indicated. 

Catalepsy. — This term is applied to a form of spasmodic 
disease, in which the limbs maintain a persistent uniform posi- 
tion during the paroxysm. Convulsions, catalepsy and epilepsy 
are modifications of the same essential malady. 

Delirium. — Mental disturbances taking the form of mania or 
insanity may occur during labor. When attended with " rush 
of blood " to the head, a flushed face, intolerance of light and 
sound, and severe pain in the head, it is apt to be mistaken for 
inflammation ; but, be it inflammation or mania, the patient . 
should never be bled nor reduced in any manner. The treat- 
ment mentioned in the preceding paragraph is applicable here. 



Disorders during Lactation. 1 1 1 



CHAPTER XVI. 

Disorders During Lactation. 

For the convenience of methodical arrangement I shall 
consider, in the present chapter, all the diseases and accidents 
which are incident to the period, dating from the completion of 
labor to the end of nursing, with the partial exception of 
hemorrhage and brain fever, which may occur during or after 
delivery, and have been treated of in the preceding chapter. 

Lacerations. — When the soft parts are bruised or torn, quiet, 
and the application of cool wet cloths should be prescribed. 
If the perineum is extensively lacerated, it is a case for the 
surgeon. In some cases the rupture extends from the vagina 
to the rectum, entirely dividing the partition between them. 
In this case the woman should keep to the bed, and be as quiet 
as possible until a competent operator takes the case in hand. 
Fortunately this accident, once so irremediable, is now among 
the curable disorders. 

Thrombus.~hn extravasation of blood into the vulva may 
occur after labor. It differs from a varicose tumor, in that the 
blood is collected in the cellular structure of the soft parts, 
instead of being contained in the vessels. It is usually caused 
by prolonged and severe pressure \ but any mechanical injury 
may occasion it — hence it sometimes affects the non-parturient 
woman. 

It may also occur during labor and greatly impede the 
delivery \ or it may cause retention of urine and fseces by 
pressing on the bladder and bowels. In some cases the tumor 
bleeds profusely. 

When the tumor impedes delivery, it should be freely opened, 
the fluid evacuated, and the further loss of blood restrained by 
the tampon. After delivery, the applications should be ice 



1 1 2 The Mother s Hygienic Hand-book. 

water, or pressure by pieces of sponge dipped in the coldest 
water. 

Retention of Urine. — When the urine is not expelled from the 
bladder, this organ becomes so stretched and enlarged as to 
form a tumor very distinctly felt at the lower part of the 
abdomen, and which is more or less painful to pressure accord- 
ing to the degree of distension. Retention should always be 
suspected when the patient has not urinated for twelve hours. 
The alternate application of hot and cold water will generally 
relieve promptly, if not, the catheter must be employed. , 

It is a singular fact that there is such a sympathy between 
certain sights and sounds and the muscles of the organs which 
are under the equal and joint control of the mental and vital 
powers, as the bowels, bladder, and uterus at full term, that 
mental impressions may frequently be employed as very efficient 
remedies. We have seen how a mental shock may suspend 
uterine contractions, and all physicians know how readily fear 
may excite inordinate action of the bowels. A mental shock 
has often paralyzed the sphincter muscles of the bladder in an 
instant, so that the urine flowed without any power on the part 
of the patient to restrain it. It is on this principle that we 
have a remedy which is often promptly effective in the case of 
retention. It consists in pouring a stream of water, within the 
hearing of the patient, very slowly from one vessel into another, 
as from a pitcher into a pail. I have known this to relieve 
instantaneously. 

Incontinence of Urine. — An inability to retain the urine is 
sometimes caused by the prolonged pressure of the presenting 
part of the child on the neck of the bladder, inducing paralysis 
of the sphincter muscles. Hot and cold applications are the 
remedies, to be applied alternately. 

Tympanites. — Great distress because of accumulated gases in 
the intestinal tract, sometimes occurs, especially after severe 
flooding or prolonged labors. In some cases the abdomen 
becomes extremely tender to the touch, when inflammation is 
apt to be erroneously diagnosticated. Sips of water, and wet 



Disorders during Lactation. 113 

cloths, of the temperature most agreeable to the patient, are 
the remedies. 

Periiieal Paralysis. — Some authors mention this as anions 
the effects of tedious labors — the perineum being pressed upon 
until its muscular tissue has lost all power of contraction, ren- 
dering defecation difficult, and constituting a great impediment 
to walking. I am of the opinion that constipated bowels have 
more to do in its causation than pressure. The remedies are, 
hot and cold applications alternated, the ascending douche, and 
electrical currents. 

After-pains. — The patient usually has a few pains soon after 
the placenta has been removed, which indicate the contractions 
of the uterus in expelling whatever coagula, fluids, or shreds of 
membranes may remain. In feeble women, those addicted to 
tight lacing, or sedentary habits, these after-pains are some- 
times severe and very distressing. The remedy consists in 
invigorating and regulating the contractions, as in the case of 
feeble or spasmodic uterine action, — alternate hot and cold 
applications, with abdominal manipulations. 

Hardened Fceces. — In some cases, indeed in many, the lower 
portions of the intestinal canal are obstructed, involving the 
rectum or colon, producing spasmodic or colic pains, a sense 
of heaviness and weakness in the abdomen, and endangering 
puerperal fever. This condition results from habitual constipa- 
tion and inattention to the movements of the bowels during 
the latter period of pregnancy. Enemas of tepid water are 
the special therapeutics. 

Suppressed Lochia. — For several days after child-birth there 
is usually a discharge from the vagina ; sanguineous at first, 
then serous or watery, and finally mucous or mucopurulent. 
The quantity depends principally on the more or less plethoric 
condition of the patient. In debilitated or gross women it 
may continue for several weeks, to be, sometimes, succeeded by 
leucorrhcea. 

When the discharge is suddenly checked or arrested in con- 
sequence of cold or other cause, the patient will suffer of deter- 



H4 The Mothers Hygienic Hand-book. 

mination to the brain, flushed face, headache, and perhaps 
delirium. Warm foot baths, fomentations to the abdomen, and 
cold applications to the head will generally relieve all the 
symptoms very promptly. 

Milk Fever. — The febrile disturbance to which this term is 
applied, usually appears in a day or two after confinement. 
Commonly there is more or less chilliness, followed by feverish- 
ness and attended with a temporary suspension of the lochial 
discharge. No treatment is required save a tepid ablution, in 
the hot stage, and warm applications to the feet if they are 
inclined to coldness. Unless the bowels are free an enema 
of warm water should be employed. 

Weed Fever. — This affection, termed also ephemeral fever, is 
similar to the preceding, but more severe, and usually appears 
about one week after confinement. It simulates a one-day 
intermittent ; the cold stage is very prolonged, the hot stage 
violent, and profuse perspiration attends the sweating stage. 
It is important not to confound this malady with puerperal 
fever. It can readily be distinguished by the absence of abdo- 
minal tenderness. The treatment is the same as for milk fever. 

Sore Nipples. — The nipples are sometimes excoriated or fis- 
sured, and become excessively tender, rendering nursing very 
distressing to the mother. The nipple should be anointed 
with unsalted beef or mutton, tallow, or simple cerate, and 
covered with a cloth wet in the coldest water, which should be 
frequently renewed. Before the infant is applied to the breast 
the ointment must be removed by means of a soft cloth or 
sponge, and warm suds of castile soap. It is better to have 
the child draw the milk through the nipple shield, as less 
washing of the nipples is required, while the child's mouth and 
nipples are each protected from the irritation of contact. It is 
important that the milk should be drawn regularly, or engorge- 
ment, inflammation, and abscess might result. 

Defective Nipple. — A flat or sunken condition of the nipple, 
sometimes accompanied with a deformed or imperfectly devel- 
oped breast, is among the incidents of motherhood requiring 
medication. The child cannot grasp the nipple so as to draw 



Disorders during Lactation. 1 1 5 

its necessary " rations," and the mother is both grieved and 
fretted because of it. 

The difficulty may be remedied in various ways, the prin- 
ciple of treatment being that of a congestor, or suction-pump, as 
in dry cupping or well-pumping. Many devices have been 
successfully employed, all connected with an air-pump ; but 
the suction bottle is generally effective, and always at hand. 
Any small bottle with a long neck, as the ordinary pint bottle 
or a quart bottle, may be filled with hot water, the water poured 
out, and the mouth of the bottle immediately applied over the 
nipple. After a few applications, sometimes after a single one, 
the child will procure its "meat" and meal without difficulty. 

Qiiaiitity of Milk. — Where the supply is insufficient the 
breasts should be fomented occasionally, followed by friction 
with a cold wet cloth • the diet should be largely of good ripe 
fruit, and all irritating and thirst-provoking seasonings avoided. 
When the secretion is too abundant, cold applications to the 
breasts and a drier dietary are proper. 

Quality of Milk.- — This must depend principally on the diete- 
tic habits of the patient. Plain simple food, well masticated, 
with little or no seasonings, and with little or no drink at meals, 
are the essentials. Nothing is more pernicious than stimulat- 
ing drinks — wine, ale, coffee, etc., so frequently commended 
as enrichers of the lacteal fluid. 

Excessive Nursing. — This term is applied to mothers who 
become sickly and exhausted while suckling their infants \ or 
who manifest a predisposition to mania or insanity. If at- 
tention to all the conditions of health does not soon arrest 
the difficulty, weaning should be commenced at once. To 
undertake to force the milk or sustain the patient by stimula- 
tion is ruinous to both mother and child. 

Nor should the mother ever nurse one child while pregnant 
with another. Pregnancy and lactation are incompatible pro- 
cesses, and for a woman to undertake to do both at the same 
time is certain to injure both herself and the present and pros- 
pective offspring, with the possibility of destroying one or all. 



1 1 6 The Mother s Hygienic Hand-book. 

Mammary Abscess. — This is one of the most common and 
one of the most distressing ailments of the lying-in chambei 
The drain on the patient's vitality is damaging to both mother 
and child, and the patient is sometimes prostrated for months. 
I have, however, never known a "broken breast" occur when the 
woman was reasonably Hygienic during pregnancy. It is always 
the result of mismanagement, bad living, or very bad medication. 

To prevent abscess from forming, the child should be early 
and frequently applied to the breast— whether it contain milk 
or not, provided it is full and tender. 

If the breast become hot and painful, cold wet cloths should 
be constantly applied until the preternatural temperature is re- 
duced. If the infant is too feeble to draw the breast properly, 
the nurse may prevent a long and tedious illness by drawing a 
little milk occasionally. If she is too awkward or fastidious to 
nurse the natural way, she may draw the milk through the nipple 
shield j a young pup is an excellent and very popular sucking 
machine^ and should be obtained if necessary and practicable. 

The diet must in all these cases be solid and as dry as possi- 
ble \ all slop food, and all fluids except for actual thirst being 
abstained from. If the patient is inclined to general feverish- 
ness, the tepid ablution daily should not be neglected. The 
feet should be kept warm, the head cool, and the room as cool 
as is consistent with comfort, and well ventilated. 

If the inflamed breast passes to the stage of suppuration 
despite all preventive measures, indicated by extreme distention, 
throbbing pains, and rigors or chills, poultices of bread and 
milk, or flour of slippery elm, should be applied. 

Puerperal Fever. This dread disease, sometimes termed 
peritonitis, is the most formidable and fatal of all the maladies 
incident to parturition. It is frequently termed child-bed fever, 
because it occurs a few days after child-birth. It is truly an 
inflammation of the peritoneum, — the lining serous membrane 
of the abdominal cavity — involving more or less the uterus and 
intestines in extreme cases. Nothing can be more discordant 
than the opinions of medical men regarding its essential nature 



Disorders during Lactation. 1 1 7 

or proper mode of treatment. While some regard the disease 
as specific, like yellow fever or small-pox, others regard it as 
ordinary inflammation with symptomatic fever, and others still 
consider it to be ordinary fever with the complication of peri- 
toneal or uterine inflammation. As to treatment, some authors 
and practitioners of eminence and experience recommend 
bleeding and the reducing regimen ; and others of equal reputa- 
tion and ability condemn depletion of every kind, and prescribe 
opium and stimulants. A third and perhaps intermediate class 
of physicians reject both the depleting and the stimulating 
plan, and rely mainly on local treatment, cathartic drugs, 
turpentine fomentations, mercurials, etc. 

M. Trosseau, a French physician, regards the disease as 
common to pregnant and non-pregnant, ante or post-parturient 
women, although the latter are much the most liable to it. His 
language is, as quoted by Bedford: "The lying-in female 
exhibits^ peculiar morbid opportimity, and presents a remarkable 
pathological aptitude for the malady." 

Such language presupposes that diseases are entities, watch- 
ing for an opportunity to " attack " some one, as a wolf watches 
for a " morbid opportunity " to get into the sheep-fold, or a 
vulture watches for some opportunity to pounce upon a lamb, 
should it exhibit a " pathological aptitude." Such absurd 
notions of the nature of disease have prevailed in the medical 
profession quite too long already. 

Some authors distinguish puerperal fever into inflammatory, 
typhoid, bilious, mucous, sporadic, epidemic, etc. These distinc- 
tions are practically useless, besides being theoretically errone- 
ous. The disease, in all cases, is inflammatory in nature and 
typhoid in form, whether it be mild or severe • that is to say, 
there is an inflammation of the peritoneum accompanied with 
a fever of the typhoid character. 

Statistics gathered from the New York, Philadelphia, Lon- 
don and Paris hospitals show that a large majority of cases of 
puerperal fever are fatal. But I have never known a fatal case 
under Hygienic treatment, and I have had several cases to 



1 1 8 The Mother s Hygienic Hand-book. 

manage, and have known of a score or more successfully treated 
by other Hygienic physicians. 

The disease usually appears the second or third day after 
delivery, with symptoms of ordinary fever, soon followed by 
extreme tenderness and swelling of the abdomen. The tension 
and pain of the abdomen are so great that the patient usually 
remains on the back and draws up the knees to relieve the 
inflamed part, and the congested organs adjacent, from pressure. 

The Hygienic treatment is as simple as it is effectual. So 
long as there is painful distention of the abdomen, with preter- 
natural heat, keep the part constantly covered with cold wet 
cloths ; free the bowels with tepid enema ; keep the feet at the 
normal temperature ; apply a cool wet napkin to the head ; sponge 
the whole surface once, twice or thrice a day, according to 
the degree of heat. If the abdomen continues painful or dis- 
tended after the morbid heat abates, apply warm fomentations 
for five to ten minutes once an hour or two. Continue these 
appliances as the symptoms appear until the patient is well. 

Milk-Leg. ~— This affection — phlegmatiadolens, of medical 
books — is so termed because of the whitish and glistening 
appearance of one or both lower extremities. It rarely affects 
but one at the same time. It is an inflammatory affection 
mostly confined to the lymphatic absorbents and glands, the 
discoloration being attributable to an obstruction of the lymph 
in its passage towards the heart. The pain usually commences 
in the groin and extends downwards, with a swelling of the 
limb ; but sometimes the pain and swelling commence at the 
feet and extend upward. The femoral vein is sometimes so 
tense as to roll under the finger like a cord. In a short time, 
if the inflammation is not promptly and properly treated, the 
limb becomes cedematous or dropsical. 

The disease is said to have a "preferential affinity " for the 
left leg, but why, no one has offered any other explanation 
than vague conjecture. 

The plan of treatment is precisely the same as for puerperal 
fever. 



Disorders of Infancy. 1 1 9 



CHAPTER XVII. 

Disorders of Infancy. 

The diseases incident to infancy seem to become more 
numerous and complicated as the habits of society become 
more luxurious, and the occupations of mothers more sedentary. 
Many of these affections are, therefore, inherited infirmities or 
predispositions, while others are due to accidents and maltreat- 
ment after birth. 

Asphyxia. — This term is properly applied to impeded respira- 
tion ; but if the child does not breathe after birth, it is often said 
to be asphyxiated, although the respiratory function has never 
been established. The child is breathless, but not pulseless, 
as in true asphyxia. 

The first thing to do is to remove all mechanical obstructions, 
if any exist, from the mouth, as mentioned in the chapter on 
management of labor. In the next place, hot and cold water 
should be applied in rapid alternation to the chest and back. 
The temperature should be a little above ioo°, and as low as 
400 if possible. Dipping the entire body in warm and cold 
water alternately, is often speedily successful in inducing 
respiration. If these measures fail, the " Ready method " of Dr. 
Marshall Hall should be resorted to, which consists in placing 
the child in the prone position, and alternately but rapidly 
changing it from this position to the side, and vice versa, 
making moderate pressure along the back and ribs while in the 
prone position. The rationale of this proceeding is, as 
explained in Dr. Hall's own words : " Experiments innumerable 
have demonstrated that if the subject be laid prone, and 
pressure briskly made on the back, there is good ^epiration, 
and that, if the pressure be removed, and the body turned on 
its side, and a little more, there is good /aspiration \ that if 



120 The Mothers Hygienic Hand-book. 

this pronation and pressure, and this removal of the pressure 
and rotation be instituted alternately, there is good respiration" 

How long the new-born child may live without breathing is 
very uncertain, and much doubtless depends on inherent vitality. 
Cases are well authenticated in which still-born infants have 
been restored after remaining breathless for an hour or more. 
The average period of resuscitation, as determined from the 
statistics which have been collected on the subject, is a fraction 
more than thirty-five minutes. 

The Blue Disease. — This is occasioned by the malformation 
of the heart, as explained in the chapter on the foetus in utero. 
Soon after birth the child's face and finger-tips exhibit a livid- 
blue color i the whole body inclines to coldness, the heart 
beats irregularly, and fainting turns or paroxysms of suffoca- 
tion occur. Nothing can be done in the way of special medi- 
cation. The child may be raised by careful attention to all 
hygienic habits. 

Occlusion of the Anus. — This phrase is applied to an obstruc- 
tion of the rectum, or lower portion of the intestinal tube, which 
prevents all discharges from the bowels. The opening may be 
closed by a thin membrane or skin, or the obstruction be an inch 
or several inches from the anal outlet. In the former case the 
obstruction can be readily incised, and in the latter a trochar 
should be introduced by a competent surgeon. When this 
difficulty exists it will be manifested in ten or twelve hours 
after birth by the distention of the abdomen, the piteous 
moaning, refusing the breast, haggard countenance, and 
general restlessness. 

Jaundice. — This affection sometimes appears soon after birth. 
It is owing to inherited torpidity of the liver. It does not require 
any special treatment. The yellowness of the skin will gener- 
ally disappear in a short time if the little patient is fed properly. 

Crusta Lactea. — This affection {milk-crust) most frequently 
occurs during dentition, but sometimes appears soon after 
birth. It consists of an eruption of irregular groups of little 
pustules upon the face and scalp, which discharge a viscid and 



Disorders of Infancy. 121 

yellow or greenish fluid. The itching is sometimes excessively 
annoying. 

Many astringent and caustic applications are recommended 
in medical books, but they are liable to repel the eruption 
to the membranes of the brain or lungs. Thorough cleanliness 
in all respects, gentle ablutions of tepid water every morning, 
and the application of a little inodorous glycerine, constitute 
the safe remedial plan. 

Apt/ice. — The " sore 711011th " of infants consists of inflamed 
and ulcerated spots, the result of disordered digestive organs or 
of irritating food or condiments. These causes sufficiently 
indicate the remedial plan. A teaspoonful of cold water, 
several times a day, will alleviate the pain and hasten the 
healing process. 

Thrush. — This and the preceding affection are indiscrimin- 
ately called canker in common parlance. It is an erysipelatous 
inflammation of the mucous membrane of the mouth, often 
extending to the stomach and intestines, and sometimes 
throughout the whole alimentary canal. The tongue and 
lining membrane of the mouth exhibit whitish granular deposi- 
tions analogous to curdled milk, which run together. It is a 
much worse disease to manage than apthae, and often renders 
nursing difficult and painful, and sometimes impossible. Foul 
air, damp rooms, unwashed nipples, sugar teats, &c, are among 
the common causes. Not unfrequently the disease in its very 
worst form is traceable to overheating, worrying, &c, on the 
part of the mother during pregnancy. The most aggravated 
cases I have ever known were clearly attributable to excessive 
toil and constant trouble of the mother preceding the period of 
quickening. 

To remedy this ailment the mother must abandon every 
indigestible or irritating article of food and drink, or wean the 
child. In either case the utmost care should be taken in 
relation to bathing, dressing, ventilation, &c. Indeed, all the 
appliances of Hygiene must be made available, or the patient 
will either die soon or become a chronic invalid for life. 



122 The Mothers Hygienic Hand-book. 

Chafing.— Excoriations often occur between the limbs, and 
under the arm-pits. The abraded surfaces should be wiped 
clean with a soft cloth wet in cool water, and dusted with fine 
flour, or rice powder. Proper attention to cleanliness will 
obviate this difficulty. 

Erysipelas. — This is a frequent affection of early infancy, and 
may affect any part of the body. It usually takes the form of 
herpes, or ringworm, but sometimes spreads rapidly over the 
surface like the fever of the same name. It is attributable to 
a bilious condition of the blood, and may be aggravated by 
irritant washes, bad soap, alcoholic stimulants, and uncleanli- 
ness. Tepid ablutions are all the treatment required. 

Eruptions. — Hot or ill-ventilated rooms, and gastric or biliary 
disorders, especially when teething, sometimes cause pimples 
resembling flea-bites to appear on the face, neck, or even over 
the whole body. They require no medication. 

Nettie-Rash. — An eruption of wheals with red bases and 
white summits raised irregularly on various parts of the body, is 
termed nettle-rash, on account of the appearance and itching 
resembling those occasioned by the sting of nettles. It is 
worse when the child is in bed, or suddenly exposed to a cool 
atmosphere, and is always aggravated by rubbing the skin. 
The cause is improper food, and the remedy, a correct dietary 
with gentle sponging of moderately cool water. 

Red-Gum. — This eruption usually appears when teething, 
and consists of small pimples, scattered or in groups, about the 
size of pin's heads, and very closely resembling the eruption of 
measles. It may, however, be easily distinguished from 
measles by the absence of catarrhal and febrile symptoms. No 
special medication is required. 

Hives. — In this affection the skin rises in blotches of a 
whitish color attended with intolerable itching. Keep the 
bowels free, and rub the parts affected gently two or three 
times a day with a soft cloth wet in cool but not cold water. 

Crying. — Healthy infants do very little crying, and never cry 
during the night. But with multitudes of babies crying seem 



Disorders of Infancy. 123 

to be the rule because health is the exception. A healthy child 
will not cry when it is hungry, unless deprived of its victuals 
until it becomes morbidly impatient, and then it is sick. A 
child may cry of hunger after its stomach is full ; because the 
food is not of proper nourishing quality, just as dyspeptics often 
feel a craving for food with an overloaded stomach. The cry of 
hunger is evinced by symptoms of uneasiness all over and 
dissatisfaction all through, such as throwing the arms about, 
turning the head to the breast, and opening the mouth to every 
thing that approaches it as though eager to swallow anything. 

A sip of water will sometimes appease the child, so that it 
will fall asleep. The mother should see to her own dietetic 
habits, that she may supply a sufficiency of wholesome nutri- 
ment ; but if this cannot be accomplished, other sources should 
be resorted to. 

The child should always take each meal from each breast, 
or one breast may become so engorged as to impair the quality 
of its secretion. And if the child is feeble, or the milk so 
abundant that the breasts are not well emptied, the milk should 
be drawn with the breast-pump, or breast-glasses worn. The 
breasts may be so distended as to be painful and render it 
impossible for the child to hold the nipple, in which case a 
little milk should be drawn with the breast-pump before the 
child is applied. 

When the child cries because normal hunger is unsatisfied, 
it becomes quiet the moment it is fed. If a child cries after 
partaking of an ordinary meal of wholesome food, it is 
certainly sick, or its clothing is in some manner wrong. 

Wheezing, or asthmatic breathing, with or without crying, 
denotes congestion or enlargement of the liver, and not, as 
some authors say, " weakness, or an asphysiated or apoplectic 
condition." 

An unappeasable, or yelling, or screcwiing cry, indicates colic. 

When sleepiness induces crying, the child manifests a 
disposition to lie down. 

Ear-ache, teething, pain in the chest, stomach, or limbs, as 



124 The Mothers Hygienic Hand-book. 

from the prick of a pin, or any injury, occasion manifestations 
which point directly to the part affected. 

If the child's cries are aggravated by coughing, it indicates 
pneumonia, or bronchitis, or a condition nearly approximating 
them. 

But a vast amount of crying is not clearly traceable to any 
exciting cause. But there is one very common cause of very 
distressing crying paroxysms, which are attributable to the 
maltreatment of parents, who mean well, but are very ignorant 
of the nature and requirements of babies. I mean injudicious 
fondling. The child is made to laugh so inordinately as to 
occasion partial delirium, or painful congestion of the brain, 
when it will yell and scream as hard as it has been forced to 
laugh — with interest. I have often seen fond but foolish 
parents raise their little children, about a year old, by taking 
hold of their little legs, as high above their own heads as they 
could well reach, and then moving them down and up with a 
rapidity that makes the child laugh excessively and convul- 
sively, with mingled emotions of pleasure and terror. But the 
laughing was soon succeeded by an irrepressible screaming. 

Some nurses have a pernicious habit of bouncing babies who 
just begin to sit up, on their knees, with a violence that 
endangers curvature of the spine, and congestion of the 
viscera. And another, and a very common manner in which 
infants from six to twelve months of age are abused by igno- 
rant or reckless nurses ought to be mentioned in this place. I 
mean holding them head downward. This will instantly quiet 
the most restless and unruly child, by inducing an apoplectic 
condition of the brain which stupefies it and destroys sensibility 
for a time. Those mothers who send their little ones into the 
parks and fields away from personal observation, should look 
to this matter, lest when Bridget has pleasant companions, and 
the child is troublesome, she resort to this method of rendering 
it good-natured ! 

Hernia. — Injudicious traction on the cord, or other improper 
management, as well as constitutional infirmity, may occasion 



Disorders of Infancy. 125 

a protrusion of the bowel at the navel, constituting umbilical 
hernia. The bowel should be gently pressed back with the 
fingers, and retained with a small piece of sheet lead secured 
with a bandage. 

Inflamniation of the navel. — After the separation of the cord, 
the navel sometimes becomes excoriated, or affected with an 
erysipelatous kind of inflammation, in some cases followed by 
ulceration and sloughing. 

Bathe the affected part with cool water, two or three times a 
clay, and keep it well dusted with rice flour, or prepared chalk. 

Locked-jaw. — The locked jaw — Trismus nascentiiwi, — which 
sometimes afflicts infants soon after birth, is generally owing to 
the inclusion of a portion of protruded intestine in the ligature 
with which the cord is tied. When this malady exists, this 
circumstance must be attended to, as in the case of hernia. 
Rudely pulling the cord at the umbilicus, before or during 
ligation may occasion inflammation, hernia, or locked-jaw, or 
c 11. Hence carefulness. 

Hemorrhage. — Bleeding from the umbilicus is of rare 
occurrence, and generally, although not always, happens soon 
after the cord becomes separated from the navel. When the 
bleeding is profuse, it 'is almost always fatal, the cause being 
a frail and cachectic condition of the whole organization ; 
cold applications, lint, or soft sponge, secured with a bandage, 
are the only available resources. The ligature and caustic are 
proper in desperate cases, but these require the presence of 
the competent medical adviser. 

Constipation. — Many infants inherit a predisposition to torpid 
bowels ; indeed, this can not be otherwise, so long as the 
majority of women are constipated during pregnancy — in fact, 
during life. And when it is considered that nearly all mothers 
use constipating food, we find ample explanation of the numer- 
ous diseases which disturb the stomach and bowels, to say 
nothing of the blood and brains, of their offspring. 

The only remedy is proper food on the part of the mother 
while the child nurses, and proper food for the child afterwards. 



126 The Mothers Hygienic Hand-book. 

Colic. — This is always symptomatic of indigestion, and the 
indirect result of constipation. The child cries spasmodically, 
and flexes the limbs by drawing them towards the abdomen. 

Give the child warm water to swallow, and foment the 
abdomen. 

Flatulence. — The causes are the same as those of colic. The 
abdomen is sometimes greatly distended, very painful, and 
seriously disturbing the respiration. The remedies are warm 
water, and fomentations. 

Retention of Urine. — If the child does not urinate soon after 
birth, it is a case of retention ; and if urination do not occur 
in twelve hours, fomentations should be applied to the abdomen 
and genital organs for a few minutes, followed by a dash of 
cool water. If these measures fail, give an enema of warm 
water, and, if need be, a warm bath, followed by gentle 
percussions to the lower part of the abdomen. 

Vomiting. — The infant may eject the contents of the stomach 
because of indigestion and distention, or improper ingesta ; 
rolling and tossing the child soon after nursing often induces 
vomiting, as does tight bandaging. Indigestible things of any 
kind, whether termed foods, drinks, medicines, or poisons, may 
occasion vomiting. Ascertain the cause and remove or cor- 
rect it. 

Hiccough. — This is a spasmodic action of the respiratory 
muscles, mainly of the diaphragm and abdominal walls, by which 
the air is forcibly pushed against the motionless glottis. It is 
always owing to gastric irritation. Sips of warm water, knead- 
ing the abdomen, percussing the spine, fixing the attention 
intensely, etc., have relieved. Many nostrums have a reputa- 
tion in the nursery, but they are not worth mentioning. 

Restlessness. — Infants and children are often restless, sleep- 
less, disposed to cry, and perverse in various ways without any 
cause apparent to the careless observer. If put to bed at the 
usual hour in apparent health, it may awake at any time, or 
many times during the night, and cry or scream as though 
severely distressed or badly affrighted. These spells are usually 



Disorders of Infancy. 127 

attributed to worms, but probably the worms are not guilty of 
making the disturbance in one case in a hundred \ the whole 
trouble comes from improper food ; the bowels are constipated, 
the liver engorged, the brain congested, and then the stupor of 
apoplexy, or some form of disquietude is inevitable. Attend to 
the diet ; let the child have an early and a light supper, and 
see that its bowels move regularly. If anything more is neces- 
sary, gi ye ^ a warm bath at bed-time. 

Ophthalmia, — The form of inflammation of the eyes which 
frequently affects frail and scrofulous children, two or three 
days after birth, is termed ophthalmia neonatorum, or purulent 
ophthalmia. It is a dangerous malady, and unless properly 
and promptly treated, the eyes may be irretrievably ruined. 
The white of the eye (conjunctiva) is the part primarily affected 
from which the inflammation, and often ulceration, extend to 
all the other structures of the eye. The disease commences 
with a slight weeping ; this is soon followed by redness • this is 
soon succeeded by a muco-purulent discharge, when the eyelids 
become agglutinated by the morbid excretion. 

In the plan of treatment the diet must be regulated, the room 
well ventilated, the whole surface cleansed with tepid water, 
and the eyes w r ashed of all adhesive matter by means of a very 
soft sponge moistened with tepid water. The lids should be 
everted so that no particle of offensive matter is allowed to 
remain. After the child falls asleep the lids should be smeared 
w T ith fresh olive oil to prevent sticking together \ these processes 
should be repeated three or four times a day. When there is 
much heat in the eyes, a gentle stream of water made to run 
upon the eyes for hours, or until the temperature becomes 
natural, and the redness disappears, has been found highly 
beneficial. 

Gravel. — Infants are subject to calculus concretions, attended 
with painful discharges of bloody urine, having a mucous 
or purulent sediment. As these concretions are the result 
of saline, earthy and mineral matters taken into the mass of 
blood, as lime, salt, saleratus, etc., the remedy consists in 



128 The Mothers Hygienic Hand-book. 

keeping them away. These complaints are comparatively 
common where hard water is employed in drinking and 
cooking. 

Dropsy of the Head. — Hydrocephalus sometimes affects the 
new-born child, or appears soon after birth. It is known by the 
enlargement of the upper portion of the head, and the remark- 
able separation of the cranial bones at the sutures and 
fontanelles. Little can be done in the way of special treatment. 
Keeping the skin open, the bowels free, the feet warm, and the 
blood pure, may enable the process of absorption to remove the 
fluids from the brain eventually. 

Inflamed Gums. — The process of teething is often attended 
with a swollen and painful condition of the gums, rendering 
the child peculiarly susceptible to other morbific influences, 
and predisposing to bowel complaints and convulsions. The 
conditions which should be especially guarded against during 
dentition, are constipation and feverishness ; unless one or 
both of these occur, nothing very serious can happen to the 
child while the teeth are passing through the gums. A proper 
dietaiy and the tepid ablution are the preventive measures. 

When the child manifests uneasiness or distress, with an 
inclination to bite or to put its fingers into its mouth, the teeth 
are nearly through the gums ; and the process may be facil- 
itated, and the irritation greatly alleviated by giving the child 
some moderately firm but elastic substance to exercise its 
growing teeth upon. Nothing can be better than the natural 
provision for this purpose — the mother's finger. Next in the 
order of usefulness are the rubber rings. Lancing the gums 
is never necessary if the bowels and skin are properly at- 
tended to. 



Disorders of Childhood. 129 



CHAPTER XVIII. 

Disorders of Childhood. 

The period of childhood, properly reckoned from weaning to 
puberty — from infancy to youth — is liable to many diseases, 
some of which are common to this and other periods of life, 
while others are peculiar to childhood. Both of these classes 
of diseases will be considered in the present chapter. 

Odontalgia. — Children seldom have toothache until the per- 
manent teeth are developed, and then stomachic derangement 
or constipation is almost always the immediate cause. I have 
known children raised from birth to adult age without the 
slightest pang of distress in the gums or teeth. Of course they 
were dieted on "strictly Hygienic principles." Whatever 
causes induce colds and fever, may predispose to toothache, 
but colds and fever never occur without there is obstruction in 
some of the respiratory organs. Fasting, and holding water in 
the mouth of the temperature that is most soothing, are the 
remedies for toothache. The warm bath and an enema of 
tepid water are proper in protracted cases. 

Dampness. — This term is commonly applied to an excretion 
of viscid matter behind the ears, which, in drying, forms a crust 
or scurf. When the scurf falls off the skin appears inflamed 
and moist, amounting to a superficial excoriation. The part 
should be washed clean with tepid water, dusted with rice 
flour, and then covered with dry lint. 

Otorrhcea. — Running at the ears is a frequent sequel of 
severe or maltreated scarlet fever or measles, but may be 
induced by colds, repelled eruptions, and other causes. Scro- 
fulous children are especially liable to this affection. Syringing 
the ear gently with tepid water once or twice a day is all the 
special treatment indicated. The cure must be effected by the 

9 



130 The Mothers Hygienic Hand-hook. 

means which improve the general health. When deafness 
results, electricity is appropriate. 

Otalgia. — Earache may be the consequence of inflammation, 
or it may be of a neuralgic character ; apply warm wet cloths. 

Otitis. — Inflammation of the ear is manifested by a violent 
burning, itching, or throbbing pain, deep seated in the ears, 
accompanied with general feverishness. Apply cold or cool 
wet cloths so long as the feverish heat continues ; afterwards 
tepid or warm applications. The fever should be treated with 
tepid or moderately cool ablutions, repeated with a frequency 
to be regulated by the degree of external heat. The wet-sheet 
pack is admirable when well managed. 

Colds and Coughs. — Recent colds can be successfully treated 
with the warm bath. It should be taken at bed-time, and 
continued each evening until the symptoms disappear. Coughs 
are never dangerous in themselves, and are promptly relieved 
by means of warm foot baths, and sips of warm water. But 
when coughing is symptomatic of influenza, pneumonia or other 
maladies, the treatment must be directed to the primary 
malady. 

Whooping Cough. — This well-known contagious disease may 
affect infants, but is more common in children after weaning. 
The early symptoms do not differ essentially from those of a 
common cold, attended with cough, and may continue with 
varying degrees of severity for about two weeks, when the 
peculiar u whoop" settles the diagnosis. After this the 
coughing is attended with paroxysms of strangling and the 
expectoration of a tenacious mucus. Vomiting is a frequent 
concomitant of these convulsive paroxysms. In extreme cases 
blood runs from the mouth, nostrils, eyes, and ears. This 
stage usually lasts two or three weeks, when, if the case has 
been properly managed, convalescence is rapid ; otherwise the 
malady may linger for months, if it do not ultimately terminate 
in consumption. 

The Hygienic treatment always renders whooping cough 
mild, and its duration comparatively brief. The paroxysm of 



Disorders of Childhood. 131 

coughing can be relieved by draughts of warm water, and the 
general feverishness allayed with tepid ablutions. If the 
patient complains of much soreness of the chest, or is very 
restless during the night, a warm bath at bed-time is appro- 
priate. The bowels should be kept free, and all clogging 
or " bilious " articles, as butter, sugar, grease, &c, excluded 
from the dietary. 

Croup. — This is one of the most common maladies of early 
childhood. Scrofulous and plethoric children are most subject 
to it. All " rich " (gross) kinds of food predispose to it, as 
candies, sweet cakes, greasy admixtures, fried dishes, &c. 

Authors distinguish two forms of croup : true and false , or 
membraneous and non-membraneous. But they only differ in 
degree. In the former case the fibrinous exudation which 
forms on the mucous lining of the wind-pipe {trachea) concretes 
into a membraneous covering, and in the latter case, the 
excreted matter is expectorated without consolidation. 

The early symptoms are wheezy inspiration, with some diffi- 
culty of breathing, without fever, soon followed by the shrill, 
ringing inspirations and oppressed breathing which are pe* 
culiar to the disease. The patient now manifests the low or 
typhoid form of fever which is an essential accompaniment. 
After a few hours, or days, the symptoms will gradually dis- 
appear, or the patient will die of exhaustion or suffocation. 

The essential point in the successful treatment of croup is to 
check the exudation into the wind-pipe, and prevent the forma- 
tion of what is called a false membrane, as this must necessarily 
be detached from the mucous surface, and if it is not expelled 
through the narrow glottis, the patient must be inevitably 
choked to death. 

The throat must be enveloped in cold wet cloths, the colder 
the better — and often renewed until the preternatural heat is 
subdued. In extreme cases pounded ice is better. If the 
surface is hot and feverish, tepid ablutions are indicated as in 
the hot stage of all fevers and inflammations. If the super- 
ficial heat is unequal, and the extremities inclined to coldness, 



132 The Mothers Hygienic Hand-book. 

the warm bath and hot applications to the feet are necessary. 
The expectoration of the adhesive excretion may be facilitated 
by means of sips of warm water, and the vapor or steam of 
hot water. The early treatment should always be prompt and 
vigorous, as, in most cases, the result depends on arresting the 
morbid excretion at once. 

Diphtheria. — This affection differs from the former only in the 
fact that the seat of the exudation is principally in the mouth, 
while in croup it is principally in the wind-pipe. Each may run 
into the other, by the extension of the local inflammation. In 
diphtheria, however, the fibrinous matter exuded on the mucous 
surface does not concrete into a false membrane as it may in 
croup, owing to the different locality. In many cases the 
masses of matter washed from the tongue, tonsils, and mouth, 
resemble patches of semi-concreted membranous matter, — a 
fact which indicates the pathological identity of croup and 
diphtheria. 

The plan of treatment is precisely the same as that for 
croup, with the exception that, as the mouth is the seat of the 
exudation, cold water or bits of ice can be advantageously 
applied directly to the inflamed part. Pieces of ice may be 
kept in the mouth, and allowed to melt, or finely shaved or 
pounded ice put into the mouth to produce more rapid 
refrigeration. 

There is little danger of this formidable disease, which often 
desolates the family circle of all the little ones, terminating 
fatally, if this plan of treatment is thoroughly carried out — 
unless in a very frail and scrofulous child. Nor have I yet 
known it fail in but one such case. 

Pnewnonia. — Inflammation of the lungs is among the 
diseases that are charged with destroying multitudes of chil- 
dren. But I cannot regard the disease, although very distressing, 
as essentially dangerous. Pneumonia {pneumonitis) is always 
attended with fever, which may be of the inflammatory or 
typhoid form ; and if typhoid, it may be of the kind termed 
putrid, or that termed nervous. The local affection (inflam- 



Disorders of Childhood. 133 

marion) may involve one lung or both. The symptoms are 
pain in the chest, aggravated on coughing, coughing, short 
breath, expectoration, and general fever. 

The difficulty and all the danger in pneumonia consist in 
disproportionate accumulation of blood in the lungs. This 
occasions a sense of weight or heaviness, and impedes the full 
expansion of the lungs. But, as the structure of the lungs is 
mainly a spongy mass of fibrous channels and air cells, the 
organs can bear an immense engorgement or congestion with- 
out disorganization. All that is necessary to restore health is 
to determine the blood from the lungs to other parts of the body, 
and thus restore the balance of circulation. 

The treatment may vary according to the temperature of the 
body. If the whole surface is preternaturally hot, the tepid 
bath; or tepid ablutions, are proper. If the patient is chilly, 
apply warm fomentations to the abdomen, and warm applica- 
tions to the feet. If some parts of the surface are hot and 
others cold, apply fomentations to the cold places, and cold wet 
cloths to the hot places. Move the bowels (unless diarrhoea 
exist) with tepid enema. If the cough is distressing, or the 
expectoration difficult, let the patient have frequent draughts of 
warm water. Where the patient is thirsty, cool water may be 
allowed without restraint, until the sensation is allayed. 

Influenza. — This is a modified form of pneumonia, the 
peculiarity consisting of a slight catarrhal complication. 
There is extreme congestion of the lungs with little acute pain, 
and a low form of fever. The " epizootic " of animals, some- 
times called " catarrhal fever," is nothing more nor less than 
influenza. The treatment is the same as for pneumonia. 

Bronchitis. — As commonly employed, this term is a mis- 
nomer, for it is usually applied to affections of the mouth and 
upper part of the wind-pipe, — "throat ail," and laryngitis. 
The real bronchitis is an inflammation of the mucous membrane 
which lines the ramifications of the wind-pipe (bronchial tubes), 
in the lungs. When authors describe it as " commencing with 
the common catarrhal symptoms," &c, they confound it with 



134 The Mothers Hygienic Hand-book. 

pneumonia and influenza. Its symptoms differ from these 
diseases mainly in the sense of pain and soreness or heaviness 
being more diffused, the difficulty of breathing greater, and the 
expectoration more copious. But as the symptoms so closely 
resemble pneumonia, and as it requires precisely the same 
treatment, it is hardly worth while for the non-professional 
reader to attempt the differential diagnosis. 

Catarrh. — Children are not often affected with chronic 
catarrh, but the acute form is frequently occasioned by undue 
exposures. It is an inflammation of the mucuous membrane 
of the nostrils, manifested by dryness, irritation, and sneezing, 
succeeded by smarting, and a mucous, and then muco-purulent 
discharge. Abstemious diet, a warm bath, hot and cold foot- 
baths, and an equable temperature, constitute the remedial 
plan. 

Crowing Disease. — This is a spasmodic affection of the 
muscles of the wind-pipe (trachea), which closes the glottis and 
threatens suffocation. It is termed crowing disease or crowing 
inspiration, because the patient makes a noise similar to that 
attending the inhalation of air in croup or whooping cough. 
It is also known in medical books by the terms " spasm of the 
glottis,'' 1 " asthma of children" and "laryngismus stridulus" 

During the paroxyms, which occur at irregular intervals, the 
patient struggles for breath and seems to be actually strangling. 
In some cases the struggling terminates in a general convul- 
sion. If coughing or crying occur the paroxysm is ended. 

The warm bath, fomentations to the abdomen, and cold 
water or ice in the mouth, are the remedies. If the warm bath 
is not immediately available, use the warm foot-bath, and 
dash warm and cold water alternately on the spinal column. 

Mumps. — This is a contagious disease, and consists of an 
inflammation of the parotid glands. It is known by a painful 
swelling behind the ears, with more or less feverishness. It 
affects children of all ages, though rarely infants. A warm 
bath, an equable temperature for two or three days, and an 
abstemious dietary, are all the medication required. 



Disorders of Childhood. 135 

Convulsions. — The lists of deaths of this disease are fearful, 
with a prospect of becoming more fearful, as the causes 
multiply. Constipation of the bowels is the universal immediate 
or exciting cause, while the fresh fermented bread, fried meats 
or cakes, sweetmeats, confections, indigestible pastry, and 
abominable compounds of butter, lard, eggs, sugar, and starch, 
called puddings, are the predisposing causes. I have known 
many a robust looking child of two or three years, partake of 
a hearty supper of griddle-cakes soaked in butter and molasses, 
with salted ham, or minced-pie, and sometimes the accompani- 
ments of pickles, old cheese, or dried-beef, retire to bed an 
hour later, and die of convulsions before morning. But this is 
not the place to write a lecture against " murdering the inno- 
cents." 

Tepid enemas repeated until the bowels are freely moved, 
the warm bath, fomentations, and sips of cold water are the 
remedies. 

Children who are predisposed to convulsive disease are more 
liable to have them developed during the period of dentition ; 
but it is only necessary to keep the bowels regular to obviate 
all serious consequences. 

Convulsive paroxysms often precede the eruptive stage of 
exanthems — small-pox, scarlatina, measles, and erysipelas. 
In these cases they are not alarming and need no special treat- 
ment. 

Cholera Infantum. — This is one of the " summer complaints" 
that prevail extensively during the "heated term." It is 
caused by foul air and bad ingesta superadded to constipated 
bowels. It is known by vomiting, purging, and rapid emacia- 
tion. 

Pure air is the first essential in the treatment. If the patient 
is obliged to remain in a malarious basement, stifling attic, or 
ill-ventilated room, the atmosphere should be freshened as 
much as possible by opening doors and windows, and making 
a fan of the door by swinging it rapidly to and fro. A napkin 
wet with tepid water and frequently changed, should be con- 



136 The Mothers Hygienic Hancl-book. 

stantly applied to the abdomen so long as it remains unusually 
hot. Look well to the quality of the milk which the child 
takes as food. Thousands of children are annually slaughtered 
in the cities with fictitious milk. Unless assured that the milk 
is unadulterated, and derived from cows which are properly fed, 
the safer way is to disuse it entirely. 

Diarrhoea. — Next to cholera infantum, this disease presents 
the largest bill of mortality during the summer months. The 
evacuations may be watery, slimy, bilious, or simple fecal. 
They are seldom very painful, and never attend with fever. 

Correct the dietary, keep the child quiet, and give it a warm 
bath at bed-time. 

Dysentery. — This is a very distressing ailment. It consists 
of an inflammation of the mucous coat of the large intestines, 
attended with fever of the typhoid form. The discharges are 
slimy, bloody, and extremely painful. The lower bowel is 
affected with an agonizing bearing-down sensation, termed 
tenesmus. 

Apply cold wet cloths to the abdomen constantly until the 
temperature becomes normal. Keep the child quiet, resisting 
inclinations to stool as long as possible. Treat the fever 
according to its conditions — tepid ablutions if hot, warm 
applications to the feet if inclined to chilliness, cold wet 
cloths to the head when hot and painful, &c. 

Incontinence of Uri?ie. — Wetting the bed during sleep usually 
results from constitutional debility of the urinary organs, but 
may be caused by dietetic errors. The patient should use 
mostly solid food which requires mastication ; drink nothing at 
meals, and take no slop-food, nor drink beyond actual thirst in 
the evening. The patient should sleep inclining to one side, 
instead of on the back. 

Marasmus. — This term is applied to a gradual decline, or 
" wasting away," without obvious local disease. It is usually 
attributed to some derangement or obstruction of the mesenteric 
glands ; but the true cause is indigestion. Hence attention to 
the health generally and the digestive organs in particular are 



Disorders of Childhood. 137 

necessary. Scrofulous children are generally the subjects of 
this ailment. They should have plenty of air, sunshine, and 
out-door exercise. 

Infantile Remittent Fever. — A low form of fever, attended with 
daily exacerbations and remissions, to which children are liable, 
has received this appellation. Its various phases are treated 
of in medical books as distinct fevers. Thus, when the hot 
stage is prolonged it has been termed irritative fever ; when 
delirium or great prostration exist, typhoid fever ; when the 
remission is more marked, intermittent fever ; and when emacia- 
tion is considerable, the hectic of inanition, etc. It means 
obstruction and debility. The tepid ablution twice a week ; 
the air-bath daily (rubbing the whole surface gently but briskly 
with a soft cloth) ; attention to the dietary, fresh air and 
sunshine, are the remedial resources. See that the patient 
does not use impure milk, and avoid all farinaceous prepar- 
ations which contain yeast, grease or saleratus. 

Scarlet fever. — This is one of the most prevalent diseases of 
childhood ; though rarely dangerous it is often violent, and, 
under ordinary medication, is very fatal, two and three, or 
more children, often dying in a family during an epidemic 
or endemic. It occurs in three forms, one of which is termed 
malignant, and is accompanied with ulceration of the throat ; 
another* form is accompanied with a swelling of the glands of 
the neck, often inducing partial blindness and complete deaf- 
ness, and is termed anginose ; the other form is termed scarlatina 
simplex, because the eruptive fever is uncomplicated with any 
affection of the throat or neck. In extreme cases, the eruption 
peculiar to the skin does not appear, and the patient sinks in a 
day or two after the first premonition. In the low forms of 
this disease all reducing measures, as bleeding, leeching, blis- 
tering, antimonials, or cathartic drugs, may cause death in a 
few hours, especially if prescribed at the time the eruption is 
about to appear on the surface. An ordinary dose of castor 
oil, at such time, may be as certainly fatal as a pistol ball 
through the heart, though not quite so rapidly ; while in the 



138 The Mothers Hygienic Hand-book. 

milder forms the patient may survive all of these measures, 
whether beneficial or otherwise. 

We have the testimony of eminent physicians of all the 
existing schools of medicine, that, " water treatment " is as 
nearly infallible in all forms of scarlatina, as any medication 
can be in any disease whatever — a specific ; and of the hundreds 
of non-professional persons who have treated their own and 
their neighbor's children "hydropathically," guided by such 
information as they could gather from the Hydropathic Ency- 
clopaedia, all have had excellent success — the deaths being 
less than one in a hundred cases. 

The required treatment is exceedingly simple. In the mild 
or simple form, a tepid enema to free the bowels, and tepid 
ablution once or twice a day, according to the degree of 
superficial heat, is all the medication necessary. 

The anginose form requires precisely the same treatment, 
with the addition of cold wet cloths around the neck so long 
as the swelling is troublesome. 

In the malignant form the febrile symptoms are extremely 
variable, and must be managed accordingly. The coldest 
applications should be made to the throat, and sips of iced 
water or bits of ice, taken into the mouth to arrest the local 
disorganization ; no cold applications should be made to any 
other part of the surface : if the skin is hot, sponge it with 
tepid or moderately cool water, being very careful to wipe it 
immediately dry with soft flannel. Be careful to keep the 
lower extremities warm, and if the patient is inclined to chilli- 
ness, or is extremely restless, while the skin is dark-red or livid, 
but without preternatural heat, apply fomentations to the 
abdomen and warm bottles or hot sand bags to the arm-pits. 

Because the " cold water cure " has been found efficient in 
so many cases of mild scarlatina, do not apply it to the malig- 
na?it cases. The Hygienic System contemplates the use of water 
of all temperatures, as each may be most remedial under the 
ever-changing circumstances of the disease. 

Small Pox. — This disease sometimes " attacks " infants, but 



Disorders of Childhood. 139 

more frequently children. It exists in two forms, mild and 
malignant, technically termed distinct and confluent, or inflamma- 
tory and typhoid. In the former variety the pustules are 
distinct, each with a defined boundary like a boil or abscess ; 
in the latter variety the pustules do not mature well, but spread 
over the surface and coalesce, so that the surface is raised in 
livid uneven patches, often terminating in sloughing and the 
formation of extensive scars or, deep pitting. 

The patient is more or less indisposed previous to the febrile 
excitement, which is rather absurdly called the " invasion " of 
the disease ; this stage usually lasts two or three days, when 
the eruption appears in little elevations or pimples, first on the 
face, extending thence to the neck, chest, back and upper 
extremities. 

Preceding the eruption the patient is generally affected with 
violent pains in the back, drowsiness, convulsive paroxysms, 
and often hiccough and delirium. 

The pimples, at first of the size of a pin's head, enlarged to 
the size of a small pea, having a central depression and a florid 
or crimson circumference by the third day • soon after, the 
fluid in the vesicle becomes of yellow-white appearance. The 
vesicle (pock) is usually fully formed and begins to suppurate 
on the sixth day, attended with burning pain. Dessication 
commences in ten or twelve days from the first appearance of 
the eruption, when the matter (pus) hardens into a crust of a 
brownish color ; in four or five days the crusts are cast off, 
leaving reddish-brown spots, scars, or pits. 

The pock vesicles sometimes affect the mucous membrane of 
the wind-pipe and larynx, and if they are numerous near the 
glottis, endanger death of suffocation. The plan of treatment 
should contemplate the expulsion of the globules or corpuscles 
which constitute the contagion of the malady, through the 
cutaneous emunctory, and the prevention of the disorganization 
of the skin as much as possible. And this is mainly to be 
accomplished by keeping the temperature of the surface as 
nearly to the normal standard as possible. As soon as the 



140 The Mothers Hygienic Hand-book. 

hot stage of the fever is established, the hydropathic wet-sheet 
pack, or the full bath, warm, tepid or cool, is the proper 
appliance. If these are not practicable, tepid or cool ablutions, 
repeated with a frequency to be measured by the degree of 
heat, should be employed \ a prolonged tepid bath from twenty 
to thirty minutes, or a wet-sheet pack for an hour, will often 
relieve all the distressing symptoms, and render the patient 
comparatively comfortable. If these measures are vigorously 
managed, the patient kept in a shaded or nearly dark room, 
with abundant ventilation, and of a moderately cool but not 
chilling temperature, pitting will rarely occur. I have known 
many cases of infants, children, and adults, in which no spot 
nor blemish remained to tell of the loathsome malady after a 
few weeks. 

During the premonitory stage the bowels should be kept 
free, by means of tepid enema if necessary, and all irritating 
or stimulating ingesta or condiments sedulously avoided. 

Varioloid. — This is " modified small-pox," that is to say, the 
disease (rariola) occurring after successful vaccination. It 
is usually of shorter duration and milder form than variola. 
Tepid ablutions and an abstemious dietary, are the only rem- 
edies required. 

Vaccination. — Hygienists are not entirely agreed as to the 
propriety of vaccination as a preventive of small-pox. It is 
certainly an evil in itself, and whether a greater or lesser evil than 
variola depends on many circumstances. The operation con- 
sists in inserting the vaccine virus, taken from a cow, into the 
skin. Inoculation means, properly, insertion of the matter of 
small-pox taken from human beings. 

I do not believe in the theory of vaccination, nor inoculation, 
but admit that it may, under many circumstances, be the lesser 
of two evils. My work " Hand-Book of Hygienic Practice," in 
the following paragraph expresses the views of the radical 
Hygienists on this subject. 

Vaccina. — Vaccinia, Cow-Pock, Kine-Pock^ Inoculated Cow- 
Pox. The small-pox of the cow, called cow-pox, when trans- 



Disorders of Childhood. 141 

mitted to man, will, in most cases, protect him from small-pox. 
Though medical authors are very fond of boasting of the 
discovery of Dr. Jenner (whom the profession persecuted), it 
has long been a controverted question whether his discovery of 
vaccina, as a preventive of small-pox, has been a blessing or a 
curse to the world. We are of opinion its evils immeasurably 
overbalance all the good the world has derived from it. There 
is something revolting to plain, unsophisticated common sense 
in the idea of infecting the blood of a healthy person with some 
bane or baleful thing, some venom or virus, to produce immu- 
nity from disease ; yet it is in character with the whole drug 
system ; and quite recently syphilization has been gravely pro- 
posed as a preventive of venereal disease. And why not ? If 
persons ought to be poisoned because they are sick, the same 
reason would poison and infect them to preserve health ; and 
it does. The vaccine virus is usually taken from the human 
vesicle \ but this exposes the inoculated person to a worse 
infection than that of small-pox. Scrofula and venereal disease 
are often communicated in this way. Vaccina requires no 
other treatment than a daily ablution, with due attention to the 
dietary. 

Chicken-Pox. — This is also termed bastard small-pox — in 
medical language, varicella. It is an unimportant affection, 
and is characterized by transparent vesicles, scattered over 
the body, about the size of peas. Cleanliness is all that need 
be attended to. 

Measles. — There are two varieties of this disease, termed 
mild, or simple, and black, or malignant. They are analogous 
to the two forms of small-pox, and, like them, depend on the 
lesser or greater degree of grossness, or impurity of the blood. 

Catarrhal symptoms are the usual premonitions of measles, 
as sneezing, cough, difficulty of breathing, and, in some cases, 
closely simulating pneumonia. Weak and scrofulous children 
are liable to various sequelae, as bronchitis, catarrh, ophthalmia, 
chronic cough, ear-ache, &c. ; children seldom have the danger- 
ous form of this disease, although if it supervene upon teething, 



142 The Mothers Hygienic Hand-book. 

whooping-cough, or any pulmonary affection, it is liable to be 
prolonged and severe. 

The treatment is very simple — tepid ablutions, according to ' 
the degree of feverish heat, enemas when the bowels are 
costive, and a dietary very abstemious and as simple as apple- 
tea and water-gruel. 

Should the eruption suddenly recede from the surface, and 
the patient become prostrated, delirious, comatose, or exces- 
sively restless, the warm-bath and persevering frictions should 
be employed to reproduce it. 

Roseola. — This term is applied to various eruptions of a 
trifling character, more or less simulating those of the eruptive 
fevers. It is not contagious as all eruptive fevers are ; and 
requires no other attention than the employment of a tepid 
ablution daily. 

Worms. — Children are liable to be troubled with several 
species of entozoa, the most common of which are the long round 
worm (feres) which are found in the upper part of the intes- 
tinal tube, and the slender white vermicular threads, termed 
pin worms (ascarides), which infest the lower bowel. 

Physicians are not agreed whether worms are natural and 
necessary as scavengers to devour the offal of the alimentary 
canal, or whether they are simply nuisances. It is certain, 
however, that a perfectly healthy person has no accumulated 
offal, and if he had, there are better methods of disposing of it 
than to carry a colony of devouring loathsome reptiles or 
miniature serpents. 

Vermifuges innumerable are recommended to mothers for 
wor?ny children, and are often administered on the most vague 
suspicions of the existence of the animals. I have known a 
dietary divested of all constipating and offal producing materials 
to remove all symptoms of worms in due time. Fine flour, 
old cheese, butter, sugar, and all greasy substances should be 
excluded. Bread of unbolted grain, ripe fruits, and vegetables 
simply boiled or baked, constitute a plan of medication that is 
death on worms ; and better than all the nostrums in existence. 



Disorders of Childhood. 143 

In a majority of cases where the presence of worms is sus- 
pected, the symptoms are owing to indigestible food or over- 
eating. There is no absolute diagnosis except seeing them in 
the ejections or dejections. 



144 The Mothers Hygienic Hand-book. 



CHAPTER XIX. 

Training of Children. 

It is a common remark that " we have no Children in 
America." I fear it is too true. There seems to be a general 
and increasing tendency to change infantile into adult humanity 
without the transitional era of childhood. This is unfortunate 
in all possible aspects ; for a forced development and education, 
like a hot-house plant, or a night grown mushroom, can only 
have a frail and short-lived organization. 

The primary maxim that should ever be kept in view in the 
training of children and in the education of youth is, " intensive 
life can never be extensive." The stimulating viands that are 
so much resorted to in order to accelerate the development 
of the bodily structures, ensure multitudinous diseases, and 
premature death. And the sensational literature that floods 
the land only intensifies the mental powers, with the results of 
moral depravity and early intellectual decline. Even our common 
school system, so admirable in some respects, is in many ways 
a forcing and ruinous process to both vital and mental energies. 

The tendency to vice and crime, to dissipation and dishonesty, 
so rampant in the land, receives its chief impetus in the habits 
of life which commence in the cradle, strengthen in childhood, 
culminate in youth, and which are generally deemed innocent 
if not salutary. 

The wise man never said a wiser sentence than, " Train up 
a child in the way it should go, and when it is old it will not 
depart from it." Next to the Golden Rule it may be regarded 
as the most important sermon on record. 

The period of childhood, as already remarked, embraces 
the transitional era from infancy to youth ; from the develop- 
ment of the teeth which achieves independent existence, to the 



Training of Children. 145 

development of the sexual organs which establishes the social 
relations. 

During this period habits must be formed, character estab- 
lished, and tendencies regulated for life. 

There is wisdom enough extant on this subject, but it is 
scattered, and needs practical association and direction. 
Thousands of writers teach in books, and pamphlets, and 
journals, and newspapers, all that need be known to make us 
w r ise unto the salvation of our children and the race. But 
their good words are so far apart, so disconnected, so unsocial, 
as to have little effect on the masses of the people. Let us in 
the present chapter gather from a few of the most available 
sources some of these " words fitly spoken," which, like the 
" apples of gold in pictures of silver," shall present the subject 
to the mind in such a manner as, if possible, to make an 
indelible impression. 

Says the Golden Age in a recent issue, in an article over the 
signature of John Bouverie Francis : 

" A Vexed Question. 

" The use of stimulants and the belief that all stimulants are 
injurious are both almost universal. Which shall be set down 
as correct — the practice or the preaching? The child is dosed 
from the hour of its birth with one or other of the various 
patented preparations whose main property is opium, a power- 
ful destroyer of the nervous system. The quantity to which 
infants become habituated would produce decided exhilaration 
in an adult unaccustomed to this form of stimulants. At least 
fifty per cent, of the children born into the world are literal 
drunkards before they are three years old, and that peculiar 
nervous condition is produced which promotes the tendency to 
resort to stimulants through life, even if it does not make it a 
necessity. We have powerful preaching on all sides on the 
grown up drunkard's appetite, and his imbecility, and fierce 
efforts at coercion to keep him from temptation, but we ignore 

10 



146 The Mothers Hygienic Hancl-book. 

the process of forming this appetite and imbecility in infancy, 
and stili regard paregoric mixtures as blessings to mothers and 
infants. 

" The tea and coffee stimulant follows as a matter of course. 
Everyone knows that these are powerful nervous excitants, and 
that intermittence brings out the same depression as the omis- 
sion of the toper's habitual dram. Everyone knows, too, that 
not a reason can be given in defence of their use that will not 
apply to any intoxicating drink to the same extent. The only 
defence is that these cannot be carried to the same ruinous 
degree. Even this is not strictly true, for it ignores the more 
subtle progress of the injury from these, and the common long 
lives of drinkers of the others, and leaves out of view the 
effect of this incessant plying of the nervous system with these 
stimulants in creating the need of others. To the moderate 
drinker, a cup of strong tea or coffee is a more powerful 
stimulant than a moderate dram. The omission of it at the 
regular time lets down the nerves even more. We begin with 
this regular use of stimulants in children, whose nerves are 
yet weak, and all the while we vigorously preach against 
spirituous, vinous, and malt drinks. We want savage and par- 
tial laws against the vendors of them. We tax spirits two 01 
three hundred per cent., and we abandon all revenue from tea 
and coffee, because we look upon it as a tax upon common 
necessities, and this in the face of a tax of forty or fifty per 
cent, on sugar. 

" Then comes the tobacco stimulant. It is safe to say that at 
least three-fourths of the males begin the use of this powerful 
stimulant in early youth, and continue it through life. Its use 
once begun, the nervous system is never free from its influence. 
The dram drinker may shut off without losing control of him- 
self, but the chewer or smoker must keep his nerves continually 
strung up with this stimulant. The only thing urged in its 
favor is that it cannot run to such serious excess. But this is 
only by a rule which agrees to ignore the origin of the nervous 
diseases which take off so many, and which, on the one hand, 



Training of Children. 147 

agrees that no other stimulant shall be held accountable for 
any of the moral and physical infirmities of the man • and on 
the other hand, that alcohol shall be held accountable for all 
the moral and physical infirmities of the drinker. And it 
magnanimously agrees to be blind to the effect that this stimu- 
lant may have in producing that state of the nerves which 
seems to make alcohol almost a necessity. 

" But after putting infancy, and youth, and adult age through 
all this course of stimulants, and after creating in the larger 
portion of mankind, the necessity, or at least the habitual use, 
we set up a crusade against a single form of the abuse — the 
alcoholic — and proceed to wage war against it by the most 
unjust laws and the most uncharitable means, and we call it 
the war of temperance. Nay, we even have the face to call it 
total abstinence. The good men and women who must have 
their tea and coffee three times a day ; the mothers who dose 
their babies with opium, and shatter their nervous systems 
before they leave their cradles \ the fathers who, beside their 
matutinal coffee and evening tea, must smoke their half dozen 
cigars, or devour their paper of fine cut per day- — meet together 
and organize into associations, and demand of legislatures the 
most severe penal laws against the sale of spirits, wine, and 
beer. And this they call the perfect work of temperance • and 
their own practices, abstinence. If there was the hundredth 
part of a possibility that they could stop the use of that form 
of stimulants, doubtless it would be something. But the result 
even then, would be the substitution of some other form of 
destroyer. 

But is this temperance, indeed ? Is it an intelligent warfare 
against this enemy to mankind ? Is it not plain enough that 
reform must begin earlier, and be more comprehensive? For 
if we have to allow that ail this course of what are called the 
milder stimulants is according to the natural wants, we shall be 
reduced to the narrow ground of the mere question of the 
merits of the different kinds of stimulants for habitual use, in 
our warfare on the drinkers of beer, wine, and spirits." 



148 The Mothers Hygienic Hand-book. 

I extract the following from one of the daily papers, prefac- 
ing it with the remark that, in multitudes of cases in which the 
drunkard's appetite, which is so incorrigible in old age, are 
attributable more to wrong feeding, slopping, stuffing, and 
dosing in infancy, than to all other causes combined. 

"Who, then, Can be Saved." 

Rev. Samuel W. Bush, who has been chaplain of the 
Binghampton Inebriate Asylum for over eight years, and who 
has recently resigned, gives the following extraordinary testi- 
mony from his experience in that institution : 

" How many persons have been permanently reformed can 
never be accurately known ; it is feared but few out of a 
hundred. This I know, that only three of the eighty-two 
patients under the first administration have continued in a 
course of total abstinence ; and all these eighty-two belonged 
to the higher class of society, and were intelligent educated 
men. Many of these are dead, and died in a manner not 
pleasant to contemplate. The rest — alas! for them." 

So much the more need of commencing with the young, and 
training them up to hate and shun the intoxicating cup. 
There is safety only in total abstinence. 

An extract from an article written for the Science of Health, 
by Mrs. S. W. Dodds, M.D., of St. Louis, Mo., a graduate of 
the Hygieo-Therapeutic College, at Florence Hights, N. J., is 
worthy the attention of every mother : 

"How we Clothe our Babies. 

" Let us glance for a moment at the clothing of the ' infant 
of the period.' First in order in the dressing of the young 
infant comes the inevitable bandage or ' roller. ' This is 
commonly made of flannel, wrapped twice around the body, 
and pinned so tightly that it is absolutely impossible for the 
child to use properly the abdominal muscles in breathing. For 



Training of Children. 149 

the first few weeks of a child's life, breathing and crying are 
almost the only exercises it is able to indulge in, and every 
garment should be loose enough to admit of free intercostal 
and abdominal muscular action. 

" But as babies' clothes are worn, we have quite the reverse of 
this. The bandage above referred to so compresses the walls 
of the abdomen, as to prevent lateral expansion, and whenever 
the infant cries, the intestines are pushed down into the pelvis, 
not unfrequently causing infantile hernia ; for at this early age 
the opening to the inguinal canal is often only partially 
closed, and it requires but little force to cause the bowels to 
protrude. 

" The next piece to be considered is the diaper, and a more 
uncomfortable article could not well be imagined. It is 
generally made of cotton flannel, doubled twice, making four 
thicknesses of this hot material, which is pinned tightly around 
the pelvis. Add to the above a thin rubber article now in our 
market, and which is used by some, and see what we have ! 
No wonder so many children have prolapsed bowels, and 
inflammation generally in that delicate region. Only think of 
it, mothers ! for two long years this heating process is kept up, 
day and night, without interruption. Suppose you bound the 
child's head or lungs up in the same way, and for the same 
length of time, what do you think the consequence would be ? 
You would probably injure those organs for life, if indeed, the 
child survived the treatment. 

"Next in order in our little toilet comes 'baby's skirt,' a 
little scrap of very fine linen, which, considering its scrimp 
dimensions, is, for all ends and purposes, a consummate 
nuisance. Then come the flannel skirts, nicely plaited or 
gathered on to a cotton band which has also to be pinned 
around the body, under the arms, so that every time baby is 
tossed around, the skirt is dragged down over the abdomen, 
thus adding another binder to the already overbound parts. 
Last comes the dress, made' of some thin material, with or 
without sleeves, according to the fashion of the times or taste 



150 The Mothers Hygienic Hand-book. 

of the mother, who very rarely knows anything about physi- 
ology, and if she did, would be indifferent to its laws rather than 
not have her child look just like other people's babies. We have 
then, you see, arms and chest relatively bare, while just 
below is the petticoat band above referred to, and just below 
that come the thick hot plaits of flannel over the little pelvis. 
In this manner the blood is drawn by over-heating the vital 
parts, and kept there ; while it is driven away from the tiny 
hands and arms, leaving them blue and cold every time the 
infant is exposed to the air. 

" The clothing of a little child, as well as that of a grown 
person, should, in the first place, be made loose enough to 
allow of the free use of the muscles. Not only that but every 
portion of the body should be covered evenly ; there should be 
as many thicknesses on the arms and chest as there are on any 
other part. As respects bandaging of an infant all that is 
needed is a piece of thin soft muslin, to be worn loosely round 
the body, for the first week or so, until the umbilicus heals. 
The undergarments should be made of soft cotton material, 
instead of flannels, as this is very apt to irritate and chafe the 
tender skin, and is one great cause of ' gum rash,' which is 
so annoying to both mother and child. A little waist should be 
made with long sleeves and high neck, with a deep hem round 
the bottom, and buttons for fastening the skirt to. This latter 
should be made of the same material, gored perfectly plain, 
with a narrow band or hem, around the top, in which to work 
the button hole. 

" In hot weather the above garment, with a gored dress, made 
with high neck and long sleeves, is all that is required. In 
cooler weather a flannel suit should be worn between the two, 
made the same as the outside dress and buttoned down the 
front. Children as a general thing are kept too warm. After 
dressing them they are often wrapped in a thick shawl, and 
placed in the warm bed beside the mother, face and all under 
cover, with not even a little hole to breathe through. Here it 
remains for hours, breathing over and over again the air laden 



Training of Children. 151 

with the exhalations from its own body and that of the 
mother's. It is also very common to allow the child to sleep 
in the same clothes it wears in the daytime. This is all wrong. 
Little folks, as well as big ones, should change all their clothes 
before going to bed, taking care to hang up for a good airing 
the ones they take off." 

In view of the fearful facts and important admonitions the 
above writers have presented, what are we to think of the pre- 
tended professional and scientific literature extant on the 
subject. I will quote from but one of the many works of this 
kind. But let us have its full title : 

" Physical Training of Children ; or, Advice to Parents. 
By P. H. Chevasse, Fellow of the Royal College of Surgeons 
of England ; Fellow of the Obstetrical Society of London ; 
formerly President of Queen's College Medico-Chirurgical 
Society, Birmingham ; author of ' Advice to a Wife in the 
Management of her own Health/ etc., etc., etc. With a pre- 
liminary Dissertation by F. H. Getchell, M. D., Clinical 
Lecturer on the Diseases of Women and Children at the 
Jefferson Medical College, Obstetrician to the Catherine Street 
Dispensary, Fellow of the College of Physicians, and Member 
of the Pathological Society, Philadelphia, Corresponding 
Member of the Gynaecological Society of Boston, author of 
the c Maternal Management of Infancy, ' " etc., etc. 

The work is elegantly bound, faultless in typography, 
systematically arranged, beautifully embellished, and of pon- 
derous dimensions. It ought to be a cyclopaedia of wisdom 
for mothers and nurses. I quote from page 49 : 

" The wet-nurse ought to take with her dinner a moderate 
quantity of either sound porter, or of mild (but not old or 
strong) ale. Tea should be taken at half-past five or six 
o'clock ; supper at nine, which should consist either of a slice 
or two of cold meat, or of cheese if she prefer it, with half a 
pint of porter or of mild ale." 

Here is the drunkard's drink recommended as a part of two 
of the daily meals, to poison the milk which the impressible 



152 The Mothers Hygienic Hand-book. 

infant is to take from her breast. But this is not all, for in the 
preceding page the author advises — 

" If she feel faint or low at eleven o'clock, let her have 
either a tumbler of porter, or of mild fresh ale, with a piece of 
dry toast soaked in it." 

When will the advocates of temperance learn that the root of 
the evil they are combating lies in dietetic alcohol and alcoholic 
medication ? 



Hygiene of Infancy. 153 



CHAPTER XX. 

Hygiene of Infancy. 

There are many little things respecting which mothers and 
nurses are apt to be careless, or of which they are really 
ignorant, that greatly affect the health, comfort, and welfare of 
the little one, and perhaps stamp it for good or evil during all 
future life. "Just as the twig is bent the tree's inclined." 
These matters will be considered in the present chapter. 

The Business of Infants — -Let all who have the care of 
infantile humanity understand that the business of infants is to 
grow. To grow normally they must be kept in a healthy con- 
dition. They must breathe freely at all times, sleep all they are 
inclined to, and eat regularly. They must have proper clothing 
and due exercise ; but this last is generally self-regulating. 

' Never mistake infants for toys or playthings. Never employ 
them to amuse yourself or entertain company. Never exhibit 
them for the purpose of reflecting the inherited charms and 
qualities of which the parents are proud — perhaps justly. In 
their own good time and manner, if they are well nourished and 
well rested, they will manifest all the virtues they possess 
without prompting. 

Recollect that character as well as flesh may be made or 
unmade in infancy. The seeds of virtue or of vice may be 
sown by a word, a look, a smile, or a blow. " Mar the young 
sapling, and the gnarled oak will tell of thee for centuries to 
come." 

Infants are as impressible as the plastic clay, and may be 
easily moulded into vessels of honor or dishonor. If born with 
a sound organization, and normally trained and educated, they 
will never show any vicious disposition, except when abused, 
and then the " ugliness " will be merely the manifestation of 



154 The Mothers Hygienic Hand-book. 

the first law of all vital organisms — self-preservation. Every- 
thing that lives must depend on itself or die. This is true not 
only of every living organism as a whole, but of each individual 
organ, structure, and tissue. It is true of the brain, the muscles, 
the nerves, the bones, and even of the white corpuscles of the 
blood. And it is a very important truth — a truth which, when 
fully realized, must greatly modify, if not revolutionize, the 
manner in which civilized nations train and educate their 
children. 

This law of self-preservation is manifested when the gorged 
infant vomits the food it cannot digest, when it sneezes because 
of dust or bad air, when it purges because of irritating matter 
or cathartic medicine in its bowels, and when it collapses into 
stupor from an overdose of " soothing syrup." The same law 
is manifested when the infant is " attacked " by mental impres- 
sions, angry words or deeds, harsh handling, or harsher looks ; 
and what is called "punishment," whether it be shaking, 
spanking, cuffing, or whipping, or any other mode of inflicting 
pain, necessarily puts the infant on its defence. And if it 
grows up in this warfare against adverse influences, the ill- 
temper and vengeful passions, thus developed and cultivated, 
will " grow with its growth and strengthen with its strength." 

They will become its " second nature." And now the great 
lesson deducible from these considerations is, never punish nor 
correct a child in anger. If you cannot keep your own temper 
you are not fit to govern a child. Never punish a child at all; 
but correct, instruct, advise, always. Civilization ought to 
learn a lesson from savage life on this subject. When the 
Indian child does a naughty thing, the parents, instead of 
whipping it, take it into the woods by itself and give it a good 
talking to. 

Children should never be scolded at all, nor reprimanded in 
company. If necessary to admonish or correct before folks, 
do it in mild language, and with gentle manner, rather suggest- 
ing the right than condemning the wrong. Nothing tends more 
to sour the disposition, alienate the affections, and harden the 



Hygiene of Infancy. 155 

heart, than wounding the sensibilities of young children by 
reproaches or criminations in presence of company. Many 
parents lose all governmental influence, all control of their 
children in this manner — the more they scold, fret, pound, or 
whip, the more undutiful the child becomes. 

The principle I am advocating ought to be applied to com- 
mon schools, and the rod abolished for ever. " Strike a man ! " 
said William Ellery Channing, in one of his thrilling 
addresses against human bondage. With a thousand-fold 
emphasis might one exclaim against striking an utterly helpless 
and non-resistant child. 

Ventilation. — As breathing is the first necessity of life, a 
proper supply of pure air is the immediate demand of infantile 
existence. The room should always be well ventilated, day 
and night, avoiding, however, a strong current or draught. A 
door or window, or both, should be more or less open during 
the night ; and if one or both parents sleep in the same bed or 
same room as the child, the greater need is there of an abund- 
ant supply of fresh air. Many more children suffer of coughs 
and colds because fresh air is excluded from the bed-rooms, 
than because it is too freely admitted. 

Never cover the child's face on any occasion, not even when 
taking it out-doors for airing or exercise. When the weather 
is cold and blustering, put plenty of clothing around its head 
as well as body, but on no account let a" veil or any other 
material come over its mouth and nostrils so as to obstruct free 
respiration. 

Temperahcre. — Infants are generally kept too near a stove or 
fireplace, or in too warm an atmosphere. The temperature of 
the nursery, when warmed by artificial heat, should rarely 
exceed 65 ° Fall.; and when lighted with gas, oil, or candles, it 
should not exceed 6o°. During the cold season, the doors or 
windows of the nursery should be frequently opened for a few 
minutes, so as to change the atmosphere of the room. This is 
still more important when the nursery is in an underground 
apartment, or low basement. Never hold the child with its 



156 The Mothers Hygienic Hand-book. 

back or head to the fire, nor allow it to sleep in such 
position. 

Light. — Darkness, during the day, is as damaging to a young 
child as it is to a young plant. Both need light and sunshine, 
or they cannot develop vigorously. The nursery can never be 
too light. It is fashionable to exclude, not only the rays of the 
sun, but all strong light, from parlors, nurseries, and even bed- 
rooms, in order to protect the colors, and save the varnish of 
the furniture. But the economy of property and style is at the 
expense of health and life. 

Of course I do not advocate the exposure of the child's head 
or face to the direct rays of the sun on a hot day, but the 
room should be sunshiny. Parasols and veils, so generally 
employed by girl-babies and young ladies, are pernicious things. 
They weaken the eyes, enfeeble the skin, predispose to conges- 
tion of the brain, and are a prolific source of headache and 
nervousness. Freckles and tan may be prevented by them, 
and a more pale and expressionless face secured ; but it is at 
the expense of the rosy cheek, the brilliant skin, the sparkling 
eye, and the true beauty of womanhood. 

A child raised in a dismal dim-lighted building or apartment, 
will have a dismal disposition, and a dull intellect for life. Its 
hopefulness will be small, and it will be prone to dwell on the 
gloomy and melancholy. Its whole mental status will be 
stolid and selfish, and its whole organization will become 
cachectic or scrofulous. 

Dress. — The prevailing errors in the clothing of infants are 
an excess for the body, and a deficiency for the limbs. The 
legs and arms are too lightly covered or entirely exposed, 
while the chest and abdomen are overloaded with garments. 

The cap is among the abominations of fashionable infantile 
dress. The only object of it is to make the child more 
" presentable." But the health of the child, and the integrity 
of its brain, is vastly more important, to itself at least, than 
being presented to company. 

The brain is supplied with a much larger proportion of blood 



Hygiene of Infancy. 157 

than any other organ of the body, and is correspondingly 
more liable to congestion. Hence the propriety of keeping it 
more exposed than any other part. But it is very common to 
see an infant's head buried in a cap and its gaudy trimmings, 
while its neck, and perhaps arms are entirely bare. 

Great care should be exercised in adjusting the clothing of 
infants, so that no part, limb or muscle should be constrained 
in the least. Every thing should be loose and easy. This is 
especially important during sleep. The ordinary " belly-band " 
restrains the play of those muscles of the abdomen, which are 
employed in respiration, and renders free breathing impossible, 
and its effect, bad at all times, is still worse during sleep. 

It is important that stockings should fit nicely, so as to be 
sustained without garters, which are always mischievous to 
young or old; and it is especially important that shoes be 
broad in the toes, so as not to turn the toes over each other, 
stunt their growth, and produce corns and bunions. And if 
parents in dressing their children's feet, will always recollect to 
cut the toe-nails straight across instead of rounding at the 
corners, they may save much misery and decrepitude because 
of in-growing nails. 

Dr. Chavasse, before quoted, makes the following pungent, 
but truthful, remarks on the prevailing style of dressing 
children : 

" The present fashion is absurd. Children are frequently 
dressed like mountebanks, with feathers, and furbelows, and 
finery ; the boys go bare-legged ; the girls are dressed like 
women, with their stuck-out petticoats, crinolines, and low 
dresses ! Their poor little waists are drawn in tight, so that 
they can scarcely breathe ; their dresses are very low and 
short ; the consequence is, that a great part of the chest is 
exposed to our variable climate ; their legs are bare down to 
their thin socks, or, if they be clothed they are only covered 
with ' gossamer drawers,' while their feet are incased in light 
shoes of paper thickness ! Dress ! dress ! dress ! is made 
with them at a tender age, and, when first impressions are the 



158 The Mothers Hygienic Hand-book. 

strongest, a most important consideration. They are thus 
rendered vain and frivolous, and are taught to consider dress 
as 'the one thing needful/ and if they live to be women — 
which the present fashion is likely frequently to prevent — 
what are they ? Silly, simpering, delicate, lack-a-daisical non- 
entities — dress being their amusement, their occupation, their 
conversation, their everything, their thoughts by day, and their 
dreams by night ! " 

Sleep. — As already remarked, infants cannot sleep too much. 
As the assimilation of the food elements in the formation of the 
tissues, structures, and organs, takes place mainly during sleep, 
there can be no vigorous growth nor soundness of organization 
without plenty of sleep. It is, however, very important to form 
correct habits in this respect, as soon after birth as possible. 
" Rock me to sleep, mother," is a beautiful sentiment \ but it 
is better to sing in the concert-room than to practice in the 
nursery. Cradles are among the things which ought to be 
abolished, and it is a mistake to shake, or swing, or walk, or 
talk, or sing an infant to sleep. Once commence in this man- 
ner, and the baby will demand it of you as long as it is a 
baby. 

When the new-born child has had a lusty squall, inflated its 
lungs, and established the new working of its vital machinery, 
it inclines to sleep. Do not hinder it. Let it sleep as long as 
it can. And when again it appears languid and inclined to 
sleep, lay it gently on the bed, stop all noise, and remove all 
disturbing influences. If anything seems to disturb it, wait 
till it again manifests a disposition to sleep, and then repeat 
the experiment. By a little perseverance, if need be, the habit 
of sleeping when it should, will be established, to the great 
benefit of all parties concerned for a year or two. 

Drink. — Nothing but pure water should ever be swallowed 
by an infant as drink. Indeed, there is no other natural 
beverage in the universe for children or adults, for animals or 
plants. Healthy, nursing children, who have a sufficient sup- 
ply of, and proper quantity of mother's milk, do not need 



Hygiene of Infancy. 159 

drink. With others, thirst is the rule as to quantity and 
frequency. 

The author of " Physical Training of Children," heretofore 
mentioned, makes the following wholesome remarks on the 
subject of the dietary for children : 

" Some parents are in the habit of giving their children beer 
with their dinner, making them live as they live themselves ! 
This practice is truly absurd, and fraught with great danger — 
not only so, but it is inducing a child to be fond of that which 
in after-life might be his bane and curse. No good end can 
be obtained by it \ it will not strengthen so young a child ; it 
will, on the contrary, create fever, and will thereby weaken it ; 
it will act injuriously upon his delicate, nervous and vascular 
systems ; and might be a means of producing inflammation 
either of the brain or of its membranes, and might thus cause 
water on the brain (a disease to which many children are 
subject), or it might induce inflammation of the lungs." 

It is a sad pity that the learned author could not see, when 
recommending this kind of grog-food for wet-nurses, that it is 
just as bad for the child (and rather worse) to have the beer 
run through the blood of the nurse, and taken with her milk, 
as it is to have it taken directly from the brewery. 

Food. — Nature has made no other provision for the susten- 
ance of the infant than its mother's milk. But when accident, 
or disease, or disinclination, interferes with the natural supply, 
or vitiates its quality, that food which most resembles it in 
organic (not chemical) properties, should be substituted. The 
milk of a healthy wet-nurse is the next best article, and next 
in order the milk of domestic animals, of which that of the 
cow is the most available. 

I am inclined to the opinion that healthy offspring of healthy 
mothers should never be fed during eight hours of the night, 
which are best adapted for sleep. Nor can I imagine many 
exceptions in the cases of parents and children who are 
unhealthy ; the only exceptions, perhaps, being that in which 
the breasts are unusually distended with milk, or its quality so 



160 The Mothers Hygienic Hand-book. 

poor that the child is not well-nourished ; and even in these 
cases it would be better, if practicable, to draw off the surplus 
milk with the breast-pump, and supply the child, in part with 
other milk by means of the nursing bottle. 

As already intimated, few habits are more injurious to the 
child than allowing it to nurse at irregular times, because it is 
uneasy, or in pain. A child, so indulged, soon becomes " master 
of the situation," and eventually acquires a morbid craving like 
that which torments the dyspeptic adult, and which powerfully 
predisposes to that disease in after life. Whatever hours are 
resolved upon for the meals of the child, whether three or 
more, should be adhered to as regularly as the clock strikes. 

Solid Food. — So long as the child thrives, and the supply of 
milk is plentiful, there is no necessity for any other food than 
mother's milk. But the appearance of the first four teeth 
indicate when it may begin the use of other food, provided 
there is need of it. Farina, rice, oat-meal, corn-meal, rye- 
meal, and Graham flour, if finely ground, or if not, with the 
coarser flakes of bran, sifted out, are the best of the farina- 
ceous articles. They should be thoroughly boiled, or made 
into bread, and mixed with milk in gradually increasing pro- 
portions. These may be soon followed by good ripe fruits, and 
these by a moderate allowance of the more mealy vegetables, 
of which the baked potato is the best specimen. Always, 
however, observe simplicity. Only one article should be added 
to the milk for one meal. 

In all the works with which I am acquainted, sugar is 
recommended as a necessary addition to almost everything the 
child should be fed with, with the exception of its mother's 
milk. I am satisfied that this advice is wrong. I have 
dissuaded from this practice for more than twenty years, and 
so far as I am enabled to judge from much experience and 
observation, all children do better without sugar of any kind 
than with it. And the same may be said cf salt. 

I cannot too strongly deprecate the employment of fer- 
mented bread and cakes, rusks, gingerbread, pound-cake, 



Hygiene of Infancy. 161 

dough-nuts, &c, which are so generally fed to nursing children, 
as well as to those of a larger growth. I know of no article of 
food that is procurable at a bakery or grocery, that is fit for a 
child to swallow. Those who would have a proper dietary for 
the children entrusted to their charge, must purchase the pure 
materials, and prepare the victuals themselves, or have it made 
under their personal supervision and direction. 

The troublesome diarrhoea which so frequently afflicts nurs- 
ing and other children, and for which loaf-sugar, burned flour, 
roasted rice, and boiled milk are usually prescribed by physi- 
cians, is attributable to constipating food, more than all other 
causes combined. I have never knqwn a child seriously 
troubled with looseness of the bowels, who had never used 
constipating food nor taken medicines of any kind. I have 
known a few such children to live and grow from birth to man- 
hood and womanhood without any trouble of the bowels of 
sufficient consequence to need medication or require any 
special attention. And the same dietetic habits that were 
successful in these few cases might be equally successful in all 
other cases. 

Bathing. — Since the advent of Hydropathy a senseless mania 
has prevailed among certain enthusiasts that water is a remedy of 
marvellous "virtues," and that bathing, being good per se, 
could hardly be overdone in quantity or coldness of tempera- 
ture • hence the habit of some persons of washing, immersing, 
or showering, their bodies, when well, once, twice, or thrice a 
day, with little regard to constitutional conditions or ever-vary- 
ing circumstances, and with double or treble doses when sick. 
I have a letter on my desk at this writing just received from an 
intelligent gentlemen (a public lecturer on scientific subjects) 
of Liverpool, England, in which he informs me that he " packs " 
his baby, eight months old, for a " bilious humor," three times 
a day, and still the baby refuses to get well. I recommended 
him to feed the child properly, give it a tepid ablution each 
other day, and leave the rest to nature. 

Cleanliness is the real object to be kept in view in bathing 



1 62 The Mothers Hygienic Hand-book. 

children or adults as a habit ; and the frequency of the baths 
and temperature of the water should be adapted to individual 
conditions — the feebler the child the higher the temperature, 
and the less frequent the application. Feeble children should 
have more air-bathing and less water. They should be rubbed 
gently over the whole surface of the body with a soft flannel, 
or the bare hand every day while entirely nude, the room being 
kept at the proper temperature. 

All parts of an infant liable to chafing by its clothing should 
be sponged with a cool wet cloth two or three times a day ; and 
the groin and buttocks, covered with the diaper, should be 
washed thoroughly with cold water and wiped entirely dry after 
each evacuation of urine or feces. The diaper should also be 
removed the moment it is soiled, or painful excoriations may 
ensue. 

As a rule a nursing child should be washed all over once a 
day. If the child is feeble, sponging with tepid water is the 
preferable mode ; if of ordinary vigor, it may better be 
dipped in a tub of water — temperature about 85 ° — and wiped 
dry. In warm weather it may be held in the water from five to 
ten minutes ; but in cold weather one minute is long enough. 
Soap should be used sparingly, and only on places where the 
dirt adheres with such tenacity as not to be readily removed 
without it. Castile soap is the only proper kind for the delicate 
skin of a baby. Avoid salt, alcohol, vinegar, saleratus, and all 
other irritants. They should be as carefully excluded from the 
skin as from the stomach. 

Never bathe a child soon after a meal. The best time is 
when the stomach is most empty. Do not let it take food less 
than half an hour after bathing. Vigorous children should be 
bathed on first awaking in the morning, provided the room is of 
proper temperature. Weakly and restless children had better 
be bathed at bed-time and immediately put to rest and sleep. 

Exercise. — The best general rule is letaloneativeness. I am of 
the opinion that all the contrivances in the world for exercising 
the nursing infant, have done more harm than good. Left to itself 



Hygiene of Infancy. 163 

on a smooth surface out of the way of all burning or bruising 
instrumentalities, it will exercise all it can profitably, and just 
in the manner that it should. It will first demonstrate with its 
little legs and feet, and lively arms and fingers ; then roll its 
growing body about promiscuously ; next creep on all-fours, 
and next essay the perpendicular, just as nature intended 
it should, and finally walk, run, hop, skip, and jump, " in the 
way it should go." It is true that some of the fashionable ex- 
ercising apparatus in vogue — the elastic baby-jumper, for ex- 
ample — may be so nicely adjusted as to do no particular harm, 
and possibly enable the child to get on its feet sooner than it 
would if only exercised the natural way. But I fear that such 
physical development is as objectionable as precocious mentality. 

Breathing. — Some children require to be educated into the 
manner of breathing correctly. Some are born so abnormally 
that they incline to breathe through the mouth instead of through 
the nostrils ; and others acquire this habit in consequence of 
repeated colds, overloaded stomach, and other causes. 

All normal breathing is done through the nose. The mouth 
is for speaking, singing, eating, and drinking. When the respir- 
atory system is used only for breathing purposes, the mouth 
should always be kept shut, unless under violent exercise. The 
mouth should also be kept shut during sleep, with all persons 
young or old. 

The habit of breathing through the mouth instead of the nose, 
tends to weaken the whole respiratory apparatus, diminish 
the capacity of the lungs, and when commenced in early infancy, 
to distort the jaws and deform the teeth. Many of the tribes 
of American Indians (as explained by the eminent artist, the 
late Mr. Colton), are particular never to allow a child to sleep for a 
moment with its mouth open, and imsymmetrical teeth are 
unknown among them. Whenever a child is inclined to open 
its mouth during sleep its watchful mother or nurse presses its 
lips together, holds them closed, and perseveres in the corrective 
process until the abnormal habit is overcome and breathing the 
natural way established. 



164 The Mother's Hygienic Hand-book. 

Bodily Positio7is. — An infant may be distorted in its muscular 
system, or obstructed and enfeebled in its internal viscera, by 
wrong bodily positions. With children, as well as youth and 
adults, erectitude of the body is the rule. All bending should be 
at the joints, not of the chest upon the abdomen, nor of the head 
upon the chest. High pillows, which are bad for adults, are 
worse for children ; and worst for infants. The infant's bed 
should never be so soft nor its pillow so hard as to compress 
the vessels of the neck. The sleeping infant naturally assumes 
the position on the back, and its head should be raised from 
the mattress a trifle, but never enongh to bring the chin down 
nearly to the breast, nor, indeed, to produce any appreciable 
flexure of the neck. 

Never try to make a child sit uprightly without supporting 
the back until it inclines to, lest the strain upon the slender 
muscles of the spinal column cause a curvature in after-life ; nor 
urge it to stand or walk until it shows a disposition to, lest it 
become bow-legged or distorted in some manner. The only 
strictly safe rule to follow in this respect is, to let children sit, 
stand, walk, when they want to and can. 

"Baby-Talk." — Never indulge in what is commonly known 
as baby-talk, nor let any one else address your child in that 
manner. Every word or syllable that is spoken to a child, 
however young, should be distinctly articulated and correctly 
pronounced, nor should the intonations be any different from 
those which are proper when speaking to an adult. Children 
are imitative creatures. They readily imitate your manner of 
mumbling, gibbering, and distorting language, and, perhaps, 
as they grow up, will " better the instruction." You should no 
more pervert or sophisticate the language you address to an 
infant a year old or less, than you should poison or adulterate 
the food for its stomach. Language and music are the clothing 
of our thoughts and feelings, and our speech and song should 
correctly represent them. 

A child that is always addressed in proper tone and language, 
other things being equal, may speak with more propriety and 



Hygiene of Infancy. 165 

grammatical accuracy at three or four years of age, than 
another child can at eight or ten, whose " teachers of elocu- 
tion " have been baby-talkers. There is no shadow of reason 
for this silly custom. " O reform it altogether." 

Bedding. — Feather beds, which are unwholesome for all 
persons, are especially pernicious for young children. They 
enfeeble the skin, relax the muscles, and tend to the produc- 
tion of rickets and spinal curvature. Both mattresses and 
pillows should be of hair, sponge, or some similar firm and 
elastic material. A mixture of hair and corn husks makes an 
excellent and cheap material for beds. 

I repeat the caution already given, that pillows for children 
should be very small and thin. Some authors condemn them 
entirely ; and their absence is certainly a great improvement 
on the presence of the kind generally employed. 

Confections. — Cakes, candies, and sweetmeats are " slow 
poisons," when pure, and worse when adulterated. Cakes are 
an admixture of flour, sugar, and grease, and sometimes of 
saleratus or yeast in addition, and sweetmeats are concen- 
trated preparations of fruit and sugar. Both are indigestible, 
and tend to dyspepsia, and all manner of stomach and bowel 
ailments. Candies, and nearly all kinds of sugar confectionary, 
are mixed or colored with poisonous drugs, among which are 
clay, plaster of Paris, gypsum, lead, copper, mercury, chromic 
acid, and arsenic. All of these work a double mischief by 
injuring the health of the child, and destroying its relish for 
wholesome and natural food. The plainest food possible, with 
no seasonings of any kind, is the only rule on this subject, con- 
sistent with normal appetences in future life, and the highest 
degree of physical and mental development. 

Playthings. — Toys and playthings of every kind should be 
such as cannot be swallowed or put up the nose, will not cut 
or prick, and cannot poison if taken into the mouth. Most 
children have a way of testing the qualities of almost every 
thing placed in their hands by the sense of taste, and the more 
abnormal their appetites and dyspeptic their stomachs, the more 



1 66 The Mothers Hygienic Hand-book. 

prone they are to put even' thing that comes in their way into 
their mouths. Many children are born with such inheritances of 
depraved instincts that they swallow lumps of dirt, offal, and 
whatever else they can force through the gullet. Of course 
such children should be closely watched, or kept where these 
things are not obtainable. 

Colored toys for children are liable to the same objections 
as colored candies. The child may put them in its mouth and 
become poisoned with the coloring matter. Green colors are 
especially objectionable on account of containing arsenic. For 
the same reason green wall paper, green window curtains, and 
green dresses are dangerous. Nearly all contain arsenite of 
copper, which is diffused through the room in the form of 
impalpable dust. Keep lucifer matches out of the child's way. 

Unpainted wooden blocks, or bricks, are among the very 
best playthings for children. They are always harmless, and 
children never tire of them. Wooden toys which are unpainted 
and harmless can be found in sufficient variety at any toy-shop, 
so that dangerous and poisonous playthings are wholly inex- 
cusable. 

Evacuations. — Mothers and nurses are usually and justly 
very attentive to the appearances of the fecal and urinary 
discharges ; but much mischief is done in trying their abnormal 
qualities with drug medicines. The character of all excretions 
must necessarily correspond with the health of the general 
system, and the quality of the blood from which they are ex- 
creted. Hence, instead of medicating them we should purify 
the blood and restore the general health — not by cathartics, 
acids, alkrdies, calomel, opium, &c, but by diet, air, bathing, 
temperature, &c. 

If the urine is very red or dark it indicates foul blood ; if 
excessive in quantity a torpid skin, or if deficient, torpidity 
of the kidneys ; but no drugging can correct these morbid 
conditions. The fecal discharges are, when normal, of a light 
yellowish color, and semi-solid consistence. If clay-colored or 
dark, they indicate inaction of the liver \ if very dark, obstruc 



Hygiene of Infancy. 167 

tion of the lungs and imperfect respiration ; if watery, a torpid 
skin ; if hard and dry, constipation ; and if the food passes 
unchanged, indigestion, with deficient saliva and gastric juice. 
And for these various derangements thousands of children are 
annually drugged out of existence, or into a condition of 
chronic invalidism. Attend well to the hygiene, and these 
ailments will be overcome in due time. 

Teething. — The period of dentition varies much, the first 
teeth sometimes appearing before the infant is three months 
old, and in other cases not until three years of age. The 
infant usually, however, begins to " cut its teeth " (cut its gums 
with its teeth) at seven months. 

The first or temporary set of teeth consists of twenty, and 
is usually developed in pairs. The regular order is : 1. The 
lower incisors (front) or cutting teeth. 2. The upper incisors. 
3. The upper two lateral incisors. 4. The lower two lateral 
incisors. 5. First grinders in the lower jaw. 6. First grinders 
in the upper jaw. 7. Lower pointed corner or canine teeth. 
8. Upper corner teeth. 9. Second grinders in the lower jaw. 
10. Second grinders in the upper jaw. This order of the teeth 
is, however, liable to many variations. The usual period of 
dentition for the first set of teeth is about two years and a half. 

As already stated, healthy children have little trouble in 
" cutting their teeth," and no serious sickness of any kind. 
With others great distress may attend the development of the 
teeth, especially the grinders, as they press against the un- 
yielding and inflamed gums, frequently occasioning diarrhoea 
or convulsions. 

To guard against these consequences, see that, as the teeth 
are pressing on the gums sufficiently to occasion noticeable 
irritation, with restlessness, feverishness, startings during sleep, 
dreuling at the mouth, &c, the bowels are kept entirely free, 
and the skin open by warm ablutions or the warm bath. 

It is the constipated condition of the bowels, and the febrile 
state of the whole system that causes the rigidity and tender- 
ness of the gums. 



1 68 The Mothers Hygienic Hand-book. 

When the gums are very tense and painful, most physicians 
recommend lancing them. No harm is liable to result if the 
operation is skilfully performed ; but I believe it is never the 
better way. If the bowels and skin are properly attended to, 
*the inflammatory tenderness will soon disappear. And much 
of this can be anticipated and prevented by putting a teaspoon- 
ful of cold water into the child's mouth several times a day, as 
soon as the least swelling and redness of the gums are per- 
ceived. 

Some nurses give teething children very hard substances, as 
coral or ivory, to bite during teething. This is very objection- 
able. The proper articles are India-rubber, bridle-leather, the 
nurse's finger, or its own little thumb, or things of similar con- 
sistence. Some authors recommend a crust of bread, used as a 
gum-stick. This is wrong for two reasons : i. The child might 
get a piece of it into its throat and become choked. 2. Food 
should never be taken into the mouth except at meal times. 

Weaning. — Vigorous children may be taken from the breast 
without notice or previous preparation, and at once, after they 
have learned to masticate solid food ; but it is better to wean 
weakly children gradually : they should be nursed less and less, 
and fed more and more, for a few days, and then removed from 
the breast altogether. Those children that have been trained 
to eat their regular meals during the day, and sleep during the 
night, are weaned with very little trouble. 

With others it is better to send them away for a few days, 
the nurse maid feeding them once during the night with a 
bottle of new milk, kept warm in the bed. If the weather is 
very warm the milk should be boiled to prevent souring. 

Some authors recommend applying some bitter powder to 
the breast to produce aversion in the child, when it manifests 
unwillingness to give up its accustomed place and manner of 
feeding. Better let the child cry it out. It seems to me doing 
violence to its whole moral nature to do aught that could 
occasion the slightest feeling of disgust towards its mother, or 
its maternal fount. 



Hygiene of Infancy. 169 

Amusements. — These of every kind should be as much out of 
doors as the weather will permit. The difference between open 
air and house air is as much in favor of a child as of an adult. 
Indeed, it is much more important, for the dust, gases, and 
other impurities of indoor apartments which would not be 
noticed by an adult might seriously damage the more suscep- 
tible child. As soon as the little thing is able to toddle, its 
proper carpet in fair weather is the green grass, or a blanket 
spread on the elean dirt — nothing is purer than the uncontam- 
inated earth. There is no objection to the baby-carriage, as a 
means of exercise and amusement ; but in cities careless 
servant girls are very apt to jounce the infant over the gutters 
and rough places in a harsh and injurious manner, which may 
damage it for life. Every nurse should be thoroughly cautioned 
in this matter. Besides riding in its carriage, or in the nurse's 
arms, and the use of the playthings already mentioned, no 
special amusements are called for until the period of infancy 
ends with the completion of the first set of teeth. 



ijo The Mothers Hygienic Hand-book. 



CHAPTER XXL 

Raising Children by Hand. 

The essential difficulty of raising a child by hand consists in 
artificial food, which can never be a substitute for natural food. 
The practical point, therefore, is to have it as nearly natural as 
possible. We must always keep in mind the law that no being 
but its mother can produce perfect food for any living organism 
that derives its first nourishment from the breast ; no woman 
can supply another woman's child with as perfect food as she 
could, provided she was in all respects in a normal condition ; 
all artificial feeding is, therefore, the lesser of two evils. 

It happens, unfortunately, that doctors disagree as to the 
proper manner of feeding children who are obliged to be raised 
by hand, as they do on nearly all other subjects ; and in 
all the books I am acquainted with, almost every thing recom- 
mended to be eaten is vitiated or adulterated with salt, sugar, 
yeast, or poisoned with wine, or is a conglomeration of all of 
these things with fine flour and grease, and perhaps eggs. A 
majority of all the preparations of " infant food " sold in the 
shops or prescribed by medical men, is composed of two or 
more of these articles, while not one of them is fit for the 
stomach of a child. 

So far as milk is concerned, there is little to choose between 
that of a healthy wet-nurse and that of a healthy cow ; nor is 
there much to choose if both are unhealthy, as the chance for 
the child to be damaged or killed is about equal in either case. 
But, whichever is selected to supply foreign milk for the baby, 
she should be as nearly as possible in the same period of lactation 
that the mother would have been if she had nursed her own 
child ; that is, if baby is one week or one month old, the wet- 



Raising Children by Hand. 171 

nurse or cow that furnishes it milk should have been delivered 
one week or one month previously. 

Boiling the milk renders it constipating, as does the addition 
of loaf or lump sugar or salt. Brown sugar is usually dirty and 
swarming with the sugar insect which irritates the bowels and 
causes many foul humors. 

Condensed Milk (not the "concentrated," or "solidified," 
which is sweetened with loaf sugar), though not so good as 
fresh milk, has the advantage of being unadulterated. When, 
therefore, the quality of the fresh milk is suspicious, the safer 
way is to use the condensed article. This is about the con- 
sistence of thick cream, and will bear diluting with three parts 
of water to one of the condensed milk. 

As condensed milk has itself some tendency to induce con- 
stipation, the addition of loaf sugar would be more pernicious 
than when added to fresh milk. But, instead of sugar to 
aggravate its constipating effects, I would recommend the 
juices of mild ripe fruits to counteract them. Mild flavored 
apples, if entirely ripe, may be baked and the pulp mixed with 
the milk, Peas, peaches and many other fruits, can be used in 
the same manner. 

The child should never take anything into its mouth cold or 
hot. The temperature of the milk fed to it should be 90 to 95 °. 

It is impossible to feed a child properly with a spoon. The 
milk it eats should be masticated, and for this purpose it must 
be taken very slowly — almost drop by drop, from the nursing- 
bottle or some similar contrivance. This should be washed 
with scalding water every day, and emptied every time it is 
used. The sponges and rubber-nipples should be kept in 
water when not in use. 

Many attempts have been made to lay down rules for the 
quantity of milk a child should be allowed to take from the 
nursing-bottle. I do not believe the proper quantity admits of 
weighing or measurement. The correct rule is, I think, to let 
the child have its meals at regular times and then take all it is 
inclined to, never urging it to "hold on " or "let go." 



172 The Mothers Hygienic Hand-book. 

No child can thrive on the milk of a cow that is fed on slops, 
or the garbage of a city. Her food should be entirely solid, 
or such only as is well-masticated, as grass, clover, hay, straw, 
and similar forage. Most writers caution those who raise 
children by hand, to procure the milk only of those dealers in 
whom they have confidence. But those in whom we have 
the most confidence sometimes prove the most unconscion- 
able knaves. The better way is to know for ourselves, what 
we are feeding babies. 

Of the solid foods (mostly farinaceous and starchy prepara- 
tions) which are recommended in medical books as "artificial 
food " for hand-raised infants, the list is almost as long and 
almost as unhygienic, as the " bill of fare " at a first-class hotel 
or restaurant. But as those adults at the hotel or restaurant 
do best who partake only of a few and the simplest dishes, sc 
I think the babies who are raised on half a dozen kinds ol 
simple food will grow up better than those who are stuffed 
and gorged with a hundred varieties. 

Among the articles and preparations in common use are, 
arrow- root, sago, tapioca, lentil powder, fine flour, fermented 
bread, rusks, rice-powder, semolina, barley, sweet acorns, &c. 

The articles mentioned in a preceding chapter are vastly 
better — wheatmeal, cornmeal, ryemeal oatmeal, &c, with a due 
allowance of fruits and vegetables as the child grows older. 
The unbolted meal of the cereals if well ground, makes the 
best possible addition to milk. It may be made into thin 
mush, or into bread (but without yeast or risings of any kind), 
and mixed with the milk, in gradually increasing proportion^ as 
the child grows older and its teeth appear. 

For recipes and directions for cooking hygienically all kinds 
of foods, see our " Hygeian Home Cook Book." 



Accidents and Emergencies. . 173 



CHAPTER XXII. 

Accidents and Emergencies. 

An immense amount of suffering would be prevented, and 
thousands of lives saved annually, if those who have the care 
of children always knew what to do instantly in cases of 
casualties. 

Clothes on Fire. — Children are often marred for life by this 
accident. Instead of running after water, or trying to take 
the sufferer in its burning clothes to some place where water 
may be had, smother the flames at once. All you have to do 
is to cover over the burning part of the clothing so as to 
exclude the air, and the fire is ended. For this purpose throw 
around the child the first thing that is available — garment of 
any kind, blanket, shawl, sheet, carpet, or overcoat. Most 
young girls, and many women, whose clothing is a-flame, run 
out to the open air, which is just the worst thing they could do. 
They should fall flat on the floor, and thereby prevent the 
the blaze from running up the clothes to the head. By rolling 
on the floor they in many cases instantly extinguish the fire 
without assistance, and in all the cases lessen the injury. If 
some covering is not at hand, the attendant should throw the 
patient prostrate on the floor, and then seek the necessaiy 
extinguisher. 

Burns and Scalds. — Children are peculiarly liable to be 
burned or scalded as soon as they begin to run about, for if 
there is any one place on the premises more dangerous than 
another, the little walkist is sure to find it ; and as the nursery 
is often in close proximity to the kitchen stove, if not all around 
it, the chances to suffer of fire, hot irons, or boiling water, are 
many and imminent. 

A slight burning is not always to be depreciated, as it may 



174 2^ Mothers Hygienic Hand-book. 

each the little adventurer the useful and very important lesson 
of the relation of heat to its vital structures ; but if any con- 
siderable portion of the skin is disorganized the consequences 
will be serious and may be fatal. 

As there are all degrees of injury from burns and scalds, all 
kinds of constitutions which are the subject of them, as the 
great majority of burned and scalded persons recover, with or 
without the aid of the remedies employed, or in spite of them, 
and as the medicaments and specifics which experience attests, 
as useful or infallible, are as numerous as are the contents of 
the apothecary shop, there would seem to be no need of any 
trouble in managing them. But the trouble comes from the 
multiplicity of the remedies ; and as there is no general agree- 
ment among medical authors, nor among non-medical practi- 
tioners, as to what drug remedies are useful and what injurious, 
the safe " medium between extremes " is to let them all alone. 
We have already seen that water of the proper temperature, 
is all the " medicine " required for inflammation or fever, and 
a burn or scald is nothing more nor less than a local inflamma- 
tion, attended, when severe, with a constitutional febrile 
disturbance. 

But there are some circumstances peculiar to the local 
disease when caused by extreme heat suddenly applied ; and 
these require special attention. 

The first application should be the coldest water attainable ; 
to be continued until all smarting ceases. If the skin becomes 
blistered the contained fluid should be evacuated by puncturing 
the vesicles or sacs. After this, the part should be covered with 
a thick coating of fine flour. Over this dry cotton or lint should 
be applied, and if the part again becomes hot, cool wet cloths 
may be applied over the whole, and extending some distance 
beyond. When the skin is abraded so that the atmospheric 
air, some portion of which may come in contact with the 
delicate tissues beneath the cuticle, causes painful irritation, 
the temperature of the room should be raised to 8o° or 85 °, 
careful attention being paid to ventilation. 



Accidents and Emergencies. 175 

When the true skin is destroyed it is not reproduced in the 
process of healing ; but the areolar tissue which forms over 
the ulcerated surface, by contracting as cicatrization advances, 
is apt to occasion deformity unless precautions are taken. 
Burns and scalds about the neck or joints require especially 
attention when they are healing, and the part should be so 
adjusted mechanically as to prevent warping or distortion. If 
the fingers or toes are badly burned, they should be kept apart 
while healing, or adhesions may take place. 

Many domestic appliances have a reputation for alleviating 
pain and promoting the healing process. Their value depends 
on preserving an equal temperature in the part, and preventing 
the access of atmospheric air. Among the best of these, 
which are always attainable at any time, are some soft oint- 
ment, as simple cerate, tallow, cotton wool, or lint. In 
deep-seated burns, which are very painful when dressed, and 
should be exposed to the air as little as possible, there is no 
more convenient application, after the pain has been abated, 
than a dressing of fresh lard or simple cerate, over which is 
laid a covering of finely carded cotton wool. 

Burned and scalded surfaces need not be dressed oftener 
than once in two or three days, and then should be washed 
with the greatest gentleness, or the little granulations will be 
broken up and cause ugly scars. Much mischief is often done 
by "meddlesome medication." Neither soap, vinegar, spirits, 
nor any other irritant should ever be applied to the raw 
surface. 

Children sometimes get their throats badly scalded by under- 
taking to drink from the spout of a teapot or teakettle. These 
scalds are of course very dangerous. The only remedy is the 
coldest water internally and externally. 

An English author (Chavasse) asserts that one thousand 
children are annually burned to death in England by their 
cotton pinafores taking fire. This fact suggests one of three 
things. Either substitute some less combustible material for 
a pinafore, or, after washing and drying it, soak it in a solution 



176 The Mothers Hygienic Hand-dock. 

of tungstate of soda and render it fire-proof, or leave it off 
altogether. 

Bruises and Sprains. — Children suffer much, and generally 
quite unnecessarily, of injuries of all sorts and degrees, from 
the most trivial contusion to the severest sprain. All the re- 
medies ever discovered, invented, or applied, do not compare 
with simple water in remedial efficacy. All that is required for 
the best possible treatment of these injuries is, to adapt the 
temperature of the water to the circumstances of each individual 
case. The coldest water attainable, or the warmest that the 
skin can bear without blistering, or any degree of temperature 
between, may be the best for a given case. Nothing is easier 
than to ascertain by a little experimentation, what degree of 
temperature is best for the case in hand, for it happens 
fortunately that the temperature which is most agreeable is 
also most remedial. The general rule is, the more heat and 
inflammation there is in the injured part, the colder should be 
the application, and vice versa. In some very painful cases of 
sprains and bruises, hot and cold applications alternately are 
preferable. 

Wounds. — Incised wounds, or " cuts,"are made with a sharp- 
edged instrument. They bleed freely, but heal readily. When 
the blood is of a bright florid color, and is discharged in jets, 
it comes from a wounded artery of considerable diameter, and 
may require torsion or ligation, for which operation a surgeon 
should be called. If the blood flows in a continuous stream, 
and is of a dark red color, it is from a wounded vein. If mixed 
or intermediate in color, and oozing out very slowly, it comes 
from the fine capillary vessels, no large artery or vein being 
wounded or severed. 

Cold applications generally restrain the bleeding ; if not, 
compresses of lint, or fine sponge, should be applied and 
secured with a bandage or roller. 

When a large blood vessel is wounded, endangering life from 
hemorrhage, the bleeding vessel should be compressed above 
(towards the heart) the injured place, thus preventing loss of 



Accidents aizd Emergencies. 177 

blood until the surgeon can be obtained. The thumb or ringer 
may be employed to compress the artery, or the knot of a 
handkerchief may be applied over the pulsating vessel. A 
tourniquet, which has many times saved life, has been extem- 
porized by a large handkerchief, or strip of cloth, the knot, 
made as above, placed over the vessel, the cloth placed round 
the limb, and twisted with a stick passed through the loop, 
until the bleeding was arrested. 

In extensive cuts or incisions the .edges of the wound should 
always be brought together and retained by means of adhesive 
plaster, and sutures if necessary. If the parts are nicely ad- 
justed, and the inflammation regulated by simple water dress- 
ings, the wound will heal by what surgeons call the " first 
intention," that is without suppuration, leaving little or no 
scar. 

Contused wounds are injuries made by blunt instruments, as 
fragments of wood, or metal, stones, clubs, &c. They bleed 
very little, or not at all. If severe there is more or less blood 
extravasated into the areolar tissue under the skin, causing 
livid discoloration. Slight contused wounds heal by the 
process of absorption, but when severe, abscess and ulceration, 
followed by granulation and cicatrization, are the remedial 
processes. They require water dressing, as explained in the 
preceding paragraph. 

Punctured wounds are made by sharp pointed but not cutting 
instruments, as dirks, bayonets, forks, nails, &c. When deep 
they are very painful, and the danger consists in the injury to 
some vital organ, or the penetration of some large blood-vessel. 
Very little bleeding occurs unless a large vessel is wounded. 

If the heart, brain, lungs, or abdominal viscera are not seri- 
ously damaged, punctured wounds heal readily. If a nerve is 
partially severed, tetanus or locked-jaw is liable to occur; 
wounds in the palms of the hands, soles of the feet, and in 
the dense tissues around the joints, are especially liable to be 
followed by these spasmodic affections. 

Water dressings locally, and the prolonged warm or tepid 



178 The Mothers Hygienic Hand-book. 

bath, in case the body becomes feverish, or spasms occur, are 
the remedies. 

Stings of Insects. — The coldest water that can be procured 
is the remedy. Scrofulous or cachectic children are sometimes 
severely and dangerously affected by the stings of the wasp, 
bee, hornet, or even the bites of spiders, mosquitoes, or bed-bugs. 
The wound, or virus, excites erysipelatous inflammation, which 
may progress to extensive ulceration. Death has been the 
result in some cases. There is no virtue in the hundred-and- 
one specifics which appear annually in the newspapers for these 
ailments, and for the viruses of the mad dog and rattlesnake. 

Concussion. — Blows, falls, and shocks of all kinds, if suffi- 
ciently violent, produce this condition. The patient is semi- 
paralyzed, the respiration very feeble, the pulse frequent, tremu- 
lous, and intermitting ; but consciousness is seldom entirely 
lost, the patient having some use of the organs of the special 
senses, and can generally cry or speak, although with difficulty. 
The symptoms appear instantly after the infliction of the injury. 
In many cases nausea and vomiting occur, and sometimes uri- 
nation and defecation take place involuntarily. 

Perfect quiet, and plenty of fresh air constitute the whole 
remedial plan. It is the custom of some physicians to bleed 
and of others to stimulate in cases of concussion. Both are 
pernicious. 

Compression. — In the condition to which this term is applied 
there is either extravasation of blood in the brain, because of 
some shock or injury, or an accumulation of blood or serum, 
in either case inducing unconsciousness. The respiration is 
laborious and noisy, the pulse slow and irregular, all the excre- 
tory organs torpid, and the patient comatose. The eyelids are 
closed, and the pupil of the eye dilated and insensible to the 
rays of light. The bladder and bowels are so paralyzed that 
the catheter and enemas are necessary to relieve them, if the 
case is prolonged. 

Have the head raised on one thick or two thin pillows ; 
remove all tight clothing, especially about the neck ; apply cold 



Accidents and Emergencies. 179 

wet cloths to the head, and make warm applications to the 
feet. 

Once or twice a day sponge the whole surface with moderately 
warm water, rubbing gently afterwards with dry cloths. To 
relieve the bladder, apply alternate warm and cold applications, 
and move the bowels with enemas of tepid water. 

Blisters and other irritants applied to the scalp " to promote 
absorption " are worse than useless. 

Choking. — Pieces of hard bread, meat, fruit, and other sub- 
stances sometimes lodge in the upper part of the gullet 
(pharynx) and, by pressing against the glottis (entrance to the 
windpipe) endanger immediate suffocation. The obstructing 
material can generally be pushed down with the finger, or with 
any elastic rod or tube which may be accessible. A small 
piece of sponge, tied to a whalebone, or a folded rag tied over 
the end of a flexible and blunt-pointed rod will answer all 
purposes. But in nearly all cases the article can readily be 
removed ; the handle of a dessert spoon can generally be 
passed behind it, and, as the child retches, lift up upward and 
forward so as to dislodge it. In one case, when the child was 
struggling violently, in consequence of one half of an apple 
being lodged in the throat, I steadied the apple with the tines 
of a table fork in front, and the spoon handle behind, so that 
it was easily taken out. These instruments are always at hand, 
and I see no reason why they should not always be successful, 
except in the cases of very hard substances. 

When coins, pins, needles, or other metallic substances be- 
come fastened in the throat or gullet, they may be removed by 
wire loops ; but their management requires the hand of the 
skilful surgeon. 

Tickling the throat will often cause the little patient 
to retch, and perhaps vomit, and throw out the offending 
material. 

Hard substances have been removed by the following pro- 
cess, which induces a powerful expiratory effect on the respira- 
tory muscles, and indirectly on the gullet : — Place the patient 



i8o The Mothers Hygienic Hand-book. 

beneath your knees side-wise, and with your knees compress 
the belly, at the same time giving a smart blow on its back 
with your flat hand. 

Obstructio?is of the Nostril. — Children sometimes push a pea, 
bean, plum-stone, or other substance, so far up the nostril that 
it remains permanently ; in some cases held more firmly by 
the consequent swelling. It may be removed with a pair of 
forceps, director, or bent probe, but in the absence of surgical 
instruments, I have succeeded in the following manner, which 
almost any mother or nurse can imitate : — Take a common 
knitting-needle and flatten one end very thin, curving it 
slightly. This can be readily passed behind and above the 
obstructing substance, and, by gentle and steady pressure 
against it while pulling the instrument downward, the nostril 
will be cleared of its presence. 

Obstructio?is in the Ear. — Peas, beans, beads, cherry-stones, 
&c, sometimes are pushed into the external cavity of the ear, 
in the multitudinous pranks of the child. Boxing the upper- 
most ear smartly a few times, while the affected one is rendered 
undermost by turning the head to one side, is the popular and 
usually successful method of administering " corrective punish- 
ment. " Syringing the ear with warm water will in most cases 
remove the obstruction. 

When an earwig or other insect gets into the ear, the cavity 
is usually filled with olive oil, which washes the thing out 
without difficulty. But for the consolation of those who have 
not olive oil at hand, it may be well to state that simple water 
is just as effectual. 

Obstructions in the Stomach. — Should a child swallow a small 
piece of broken glass, a fragment of stone, or metal, or a pin, 
let the thing entirely alone. If undisturbed by emetics or 
cathartics it may pass through the whole alimentary canal 
without serious damage, while all attempts to remove it en- 
danger its becoming embedded in the structures and causing 
fatal ulceration. 

Coins generally pass through the alimentary canal without 



Accidents and Emergencies. 181 

trouble, and are discharged with the fecal matters. Never 
give purgatives with the view of hurrying them along. 

Foreign Matters in the Eyes. — Among the substances which 
frequently lodge in the eyelids, or in the delicate coats of the 
eyeball, are cinders, fragments of glass, or coal, particles of 
sand, quicklime, &c. They should be carefully and promptly 
removed, or the organ of sight may be irretrievably injured or 
totally destroyed. 

These substances are soon washed out by the tears, unless 
they become fixed under the upper eyelid, or impacted into 
the eyeball. To remove these the upper eyelids should be 
everted, when the foreign body can easily be seen, and removed 
with a blunt probe or any similar instrument. A fine linen or 
silk handkerchief folded over the large end of a darning-needle, 
or the head of a large pin, will readily remove ordinary particles 
of grit, dust, steel, cinders, &c. An ordinary quill writing pen 
answers a good purpose. 

When quicklime, which is a very caustic substance, has 
lodged in the eye, a weak solution of vinegar, to neutralize the 
alkali, is useful, if it can be had instantly. If not, trust to 
tepid water to wash it away, and then keep down the inflamma- 
tion by the constant application of cool wet cloths, keeping the 
eye, meanwhile, shaded against any strong light. 

If sulphuric, nitric, or any strong acid gets in the eye, a 
weak solution of soda, saleratus, potash, or any alkali, is useful, 
provided it can be promptly applied ; otherwise treat the case 
as above. 

Nose-bleeding. — Very young children are seldom troubled with 
bleeding from the nose unless from injuries, except when 
inheriting that morbid condition or cachexia known in medical 
parlance as the " hemorrhagic diathesis." Slight bleeding may 
be checked at once by pressing the nose firmly between the 
finger and thumb. Cold water applied to the nose, forehead, 
and nape of the neck, is generally effectual. A still more 
prompt remedy may be found in lumps of ice applied to the 
nape of the neck, and bits of ice placed in the mouth. 



1 82 The Mothers Hygienic Hand-book. 

Fainting. — Syncope does not often affect young children ; 
yet it may happen in infancy from fright or any strong mental 
emotion. Treat the child as you should an adult. Place 
it on its back with its head on a level with its body, and leave 
it to the efforts of nature. 

Suffocatio?i. — When suffocation results from irrespirable 
gases or mephitic vapors of any kind, the remedy is fresh air. 
Fan the patient vigorously, and if entirely breathless, treat it 
as for asphyxia, which see. 

Drowni7ig. — The directions given under the head of asphyxia 
apply here. Do not use the bellows, nor the warm bath. 

Abrasions. — For a multitude of slight wounds, injuries, and 
skin affections, not admitting of classification, as abrasions, 
scratches, cracks, fissures, chilblains, and slight cuts, there is 
no better application than gummed paper. Gum arabic, dis- 
solved in water, or the mucilage of the shops, spread on thin 
paper, answers all purposes. It readily adheres to the part, 
protects it from dust and atmospheric influences, and can be 
renewed without trouble at any moment. 



Poisons and Antidotes. 183 



CHAPTER XXIII. 

Poisons and Antidotes. 

In all cases of poisoning the first thing to be done is to 
cause the ejection of the poison by vomiting. Nothing is 
more prompt, safe, and effectual, than tickling the throat with 
a feather or the finger, and causing the patient to drink as 
much warm water as possible. When the poison admits of an 
antidote, as in the cases of acids and alkalies, this should be 
administered if it can be obtained promptly. When neither of 
these methods of treatment is available, the effects of the 
poison must be treated in the same manner as similar symp- 
toms attending the same diseases from other causes. Keeping 
these principles in mind, it is only necessary to state very 
briefly the symptoms and management of such cases as are 
common to the nursery and childhood. Nearly all of these 
may be resolved into the following classes : 

1. Acids for which alkalies are the antidotes. 

2. Alkalies for which acids are the antidotes. 

3. Acrids for which mucilages are the antidotes. 

4. Irritants for which albuminous matters are the antidotes. 

5. Narcotics for which air and temperature are the antidotes. 

6. Specifics which occasion peculiar effects, and which 

require special medication. 

7. Venoms and viruses which require to be organically 

decomposed. 

Acid Poisons. — The principal of these are sulphuric (oil of 
vitriol), nitric (aqua fortis), hydrochloric, acetic, oxalic, tartaric 
and citric. 

The symptoms are a burning sensation, an acrid taste, 
excoriation of the mouth and throat, and excruciating pain in 



184 The Mothers Hygienic Hand-book. 

the stomach. When the quantity swallowed is large, the 
extremities soon become clammy and cold, and death ensues. 

The remedies or antidotes are alkalies, as soda, potash, 
magnesia, lime, &c, &c. Baking soda, saleratus, carbonate of 
magnesia, and chalk, are salts in which these alkalies are in 
excess, and are hence antidotal. Any one of them that can be 
first obtained should be administered in a half-teaspoonful 
dose, while the patient is made to swallow as much w 7 ater 
(warm preferable) as possible, and the throat irritated with the 
finger, so as to occasion speedy and thorough vomiting. 

But it often happens that neither of these alkalies is at 
hand, and then no time should be lost in waiting for them, but 
the water-emetic treatment should be promptly and vigorously 
prosecuted without them. And whether they are immediately 
obtainable or not, the warm water, or water of any temperature 
that can be soonest procured should be given to the full capa- 
city of the patient to swallow. 

Alkaline Poisons. — The strong alkalies, like the strong acids, 
seem to burn the living structures like fire. They occasion 
intense inflammation followed by rapid disorganization. The 
principal ones are quick-lime, potash, soda, pearlash, and 
ammonia. The symptoms are similar to those produced by 
the strong acids, the chief difference being the acrid caustic 
taste. The treatment is in all respects the same as for acid 
poisoning, reversing the antidotes. The most available acids 
are vinegar, lemon-juice, citric and tartaric acids. Either may 
be given freely if largely diluted with water, — one ounce to a 
quart. 

Acrid Poisons. — Nearly all the pungent articles of the 
materia medica come under this head, as pepper, rhus, cowhage, 
nettles, croton oil, turpentine, alcohol, bryonia, gamboge, 
colocynth, cubebs, balsam of copaiba, colchicum, and a hundred 
others. 

The symptoms are a pungent taste, heat and dryness of the 
mouth and throat, extending in greater or lesser degree to the 
stomach, and, when the dose is large, excessive vomiting, and 



Poisons and Antidotes. 185 

violent purging, with great pain in the stomach and bowels. 
The patient is often semi-delirious, and in some cases com- 
pletely intoxicated. 

Warm water emetics should be employed until the contents 
of the stomach are ejected, and then mucilages, as gum arabic, 
slippery elm tea, marsh mallows, &c, freely administered. 

Irritant Poisons. — This class comprehends nearly all the 
potent mineral drugs of the materia medicas and the toxicolo- 
gies. The most important articles are, arsenic, corrosive sub- 
limate, nitre, tartar emetic, calomel, red precipitate, blue vitriol, 
white vitriol, verdigris, copperas, phosphorous, bromine, chlorine, 
iodine, and various salts of gold, silver, lead, and other metals. 

The symptoms differ but little from those of acrid poisons, 
except that their effects, as a rule, are less prompt but more 
permanent. They occasion less disturbance in the mouth and 
throat, and more in the abdominal viscera, especially the liver 
and bowels. They also depress the energies of the whole 
organic nervous system more decidedly than any other class of 
poisons except the narcotics. 

After cleansing the system of their presence as much as 
possible, as in the preceding cases, the patient should take 
freely of albuminous articles, as white of eggs, new milk, 
wheaten flour mixed with water, &c. 

Narcotic Poisons. — Under this head maybe named chloroform, 
tobacco, belladonna, stramonium, prussic acid, gelseminum, 
poke-root, aconite, strychnine, morphine, opium, conium, 
cicuta, foxglove, or digitalis, black cohosh, lobelia, ergot, &c. 

They occasion the symptoms of dizziness, stupor, delirium, 
diminished sensibility, loss of voluntary muscular motion, and 
in large doses complete unconsciousness or- anesthesia. 

These cases are to be treated precisely as apoplexy, com- 
pression of the brain, &c, — cold applications to the head, 
warmth to the feet, abundant ventilation, a cool but not very 
cold atmosphere, &c. 

Specific Poisons. — Nitrate of silver (lunar caustic), some of 
the preparations of mercury, arsenious acid, cantharides (Spanish 



1 86 The Mothers Hygienic Hand-book. 

flies), and a few other articles which are but little used con- 
stitute this class. No special medication is available in the 
nursery except the warm bath daily, and moderate employment 
of albuminous foods, and strict attention to the general health. 
Venoms and Viruses. — When the patient is poisoned by the 
insertion of any matter of infection or contagion under the skin, 
whether from a rabid animal, rattlesnake, spider, or putrescent 
carcass, the only prudential and proper treatment is to destroy 
the matter at once by disorganizing the part. If this is 
promptly and effectually done, absorption will be prevented, and 
no serious consequences follow. Any strong caustic, as aqua- 
fortis, aqua ammonia, white vitriol, chloride of zinc, &c, imme- 
diately applied to the wounded part so as to penetrate as far 
as the poison has been inserted will answer ; so will 
potash, quicklime, or whatever else is capable of disorganizing 
living matter. The application of a red hot iron, or cutting 
out the wounded part would answer all purposes if practicable. 
Unfortunately it generally happens that none of these things 
are available soon enough to prevent the poison from being 
carried into the circulation. The poison may be sucked from 
the wound without danger, as its effect when taken into the 
mouth is very different from the consequences of its insertion 
under the skin. Indeed, the virus of the rattlesnake has been 
administered as a medicine, in doses that, injected into the 
tissues, would cause the death of a dozen persons, with no 
more effect than follows ordinary doses of morphine or alcohol. 
If one of the extremities is bitten, a ligature placed around 
it, between the wound and the heart, and very near the wounded 
part, will retard the passage of the poison along the veins and 
absorbents until it can be removed or destroyed. 



THE END. 



Digestion 1 Dyspepsia. 

A Complete Explanation of the Physiology of the 
Digestive Processes, with the Symptoms and Treat- 
ment of Dyspepsia and other Disorders of 
the Digestive Organs. Illustrated, 

By R. T. TRALL, M.D. 

Bound in Muslin, - Price $1.00. 

By far the best work on the subject ever published. 
With fifty Illustrations; showing with all possible full- 
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causes, and directions for Treatment of Dyspepsia, a 
disorder w r hich, in its various forms, is the cause of 
nearly all the diseases from which the human race is 
suffering. 

The following, from the Table of Contents, will show 
something of the nature and scope of the work : 

Part I,— Digestion.— Nutrition, Insalivation, The Teeth, Deglutition, Chymi- 
ficaiion, Chylification, Intestinal Digestion, Absorption of the Nutrient Elements, 
Aeration of the Food Elements. 

Part II. — Dyspepsia. — Nature of Dyspepsia, Special Cause of Dyspepsia, 
Symptoms of Dyspepsia, Dyspepsia and Cachexies. Principles of Treatment, Food, 
Drink, Exercise, Bathing, clothing, Sleep, Ventilation, Light, Temperature, iMental 
Influences, Occupation, Tobacco Using, Tight Lacing, Position and Malposition, 
Appendix. 

The author gives the summary of the data which 
has been collected during an extensive practice of more 
than twenty-five years, very largely with patients who 
were suffering from diseases caused by Dyspepsia and 
an impaired Digestion. 

It tells you what to eat and how to eat it ; what to do 
and how to do it ; not what medicine to take and Iioav 
to take it, to cure Dyspepsia. 

Let this " Nation of Dyspeptics " procure the Book 
and read it. 

For Sale by all Booksellers, and sent by mail, post-paid, on 
erceipt of price, §1.00, by 

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W <kK S OJf 

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and Longevity. Balbirnie. 50 cents. 

Practice of Water Cure. Contain- 
ing a Detailed account of the various 
Bathing processes. Illus. 50 cents. 

Physiology, Animal and Men- 
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Restoration of Health, of Body and Pow- 
er of Mind. Illus. Muslin, $1.50. 

Principles of Physiology applied 
to the Preservation of Health and to the 
Improvement of Physical and Mental Ed- 
ucation. By Andrew Combe. $1.75. 



Sober and Temperate Life. Dis- 
courses and Letters of Cornaro. 50 cts. 

Science of Human L.ife, Lec- 
tures on. By Sylvester Graham. With 
a copious Index and Biographical Sketch 
of the Author. Illustrated. $3.50. 

Story of a Stomach. An Egotism. 
By a Reformed Dyspeptic. Mus. 75 cts. 

Tea and Coffee, their Physical, Intel- 
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By Dr. Alcott. 25 cents. 

Teeth ; their Structure, Disease and 
Management, 25 cents. 

Tobacco ; Its Physical, Intellectual and 
Moral Effects, 25 cents. 

The Alcoholic Controversy. A 
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Errors of Teetotalism. Trail. 50 cents. 

The Hath. Its History and Uses in 
Health and Disease. By R. T. Trail, M.D. 
Paper, 25 c. ; muslin, 50 cents. 

Three Hours' School a Day. A 
Serious Talk with Parents. $1.50. 

The Human Feet, Their Shape, 
Dress and Proper Care, $1.25. 

True Healing Art; or, Hygienic 
vs. Drug Medication. A practical view of 
the whole question. Pap. 30 c, mus. 50 c. 

Water-Cureforthe Million. The 

Processes Explained. Popular Errors Ex- 
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Contrasted. Rules for Bathing, Dieting, 
Exercising, etc. Pap., 30 cts., mus. 50 cts. 
Water -Cure in Chronic Dis- 
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This List embraces just such Works as are suited to every member of the family — use- 
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Aims and Aids for Girls and 

Young Women, on the Duties of Life, 
Self- Culture, Dress, Beauty, Employ- 
ment, Duties to Young Men, Marriage, 
and Happiness. By Weaver. $1.50. 

JEsop's Fables. The People's Pic- 
torial Edition. Beautifully Illustrated 
with nearly Sixty Engravings. Gilt. $1. 

Carriage Painter's Illustrated 

Manual. Art, Science and Mystery ^ of 
Coach, Carriage, and Car Painting. Fine 
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Polishing, Copying, Lettering, Scrolling, 
and Ornamenting. By Gardner. $1.00 

Chemistry. Application to Physiology, 
Agriculture, Commerce. Liebig. 50 cents. 



Conversion of §£. Paul. Py Geo. 
Jarvis Geer, D.D. i2mo. $1. 

Footprints of Life ; or, Faith and 
Nature Reconciled. A Poem in Three 
Parts. The Body, The Soul, The Deity. 
By Philip Harvey, M.D. $1.25. 

Fruit Culture for the Mi5Iion : 
A Hand-Book. Being a Guide to the 
Cultivation and Management of Fruit 
Trees. How to Propagate them. Illus. $1. 

Gems of Goldsmith.— The Travel- 
er. The Deserted Village. The Her- 
mit. With notes and a sketch of the 
Great Author. Illustrations. Gilt. $1, 

Good Man's Lejracy. Rev. Dr. Os- 
good. • 25 cents. Gospel Among 
the Animals. Same. 25 cents. 



land-Book for Home Improve- 

ment : Comprising u How to Write," 
" How to Talk," " How to Behave," and 



Ha 

MENT . 

" How to Talk," " How to Behave, - 
M How to do Business." One vol. $2.25. 

How to Liive; Saving and Wasting, 
or, Domestic Economy made plain. $1.50. 

How to Paint. A Complete Com- 
pendium of the Art. Designed for the 
Use of Tradesmen, Mechanics, Mer- 
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fessional Painter. By Gardner. $1. 

Honie for All ; The Concrete, or Gra- 
vel Wall. Octagon. < New, Cheap, Su- 
perior Mode of Building. $1.50. 

Hopes an d Helps for tli e Young 

of Both Sexes. Formation of Charac- 
ter, Choice of Avocation, Health, Con- 
versation, Cultivation, Social Affection, 
Courtship, Marriage. Weaver. $1.50. 

library of Mesmerism and 

Psychology. Philosophy of Mesmerism, 
Clairvoyance, and Mental Electricity ; 
Fascination, or the Power of Charming ; 
The Macrocosm, or the World of Sense ; 
Electrical Psychology, Doctrine of Im- 
pressions ; The Science of the Soul, 
Physiologically and Philosophically. $4. 

Life at Home ; or, The Family and its 
Members. A capital work. By William 
Aikman, D.D. $1.50 ; gilt, $2. 

Life in tlie West; or, Stories of the 
Mississippi Valley. Where to buy Pub- 
lic Lands. By N. C. Meeker. $2. 

Man and Woman considered in their 
Relation to each other and to the World, 
By H. C. Pedder. $1.00. 

Man, in Genesis and in Geol- 

OGY ; or, the Biblical Account of Man's 
Creation, tested by Scientific Theories of 
his Origin and Antiquity. By Joseph P. 
Thompson, D.D. , LL.D. One vol. $1. 



Pope's Essay on Man. With Notes, 
Beautifully Illustrated. Cloth, gilt, bev- 
eled boards. Best edition. $1. 



Oratory — Sacred and Secular 

or, the Extemporaneous Speaker. In- 
cluding Chairman's Guide. $1.50. 

Temperance in Congress. Ten 

Minutes' Speeches — powerful — delivered 
in the House of Representatives. 25 cts. 

The Christian HouselioJd. Em- 
bracing Husband, Wife, Father, Mother, 
Child, Brother, Sister. Weaver. $1. 

The Emphatic Diaglott ; or, the 

New Testament in Greek and English. 
Containing the Original Greek' Text of 
the New Testament, with an Interlineary 
Word-for-Word English Translation. By 
Wilson. Price $4, extra fine binding, $5. 

Right Word in the Right 

Place. A New Pocket Dictionary Syn- 
onyms, Technical Terms, Abbreviations, 
Foreign Phrases, Writing for the Press, 
Punctuation, Proof-Reading. 75 cents. 

The Temperance Reformation. 

History from the first Temp. Society in 
U. S. By Armstrong. $1.50. 

The Model Potato. The result of 
20 years' investigation and experiment in 
cultivation and cooking. By McLarin. 
Notes by R. T. Trail, M.D. 50 cents. 

Thoughts for the Young Men 

and Young Women of America. By 
L. U. Reavis. Notes by Greeley. $1.00. 

Ways of Life, Showing the Right Way 
and the Wrong Way. Weaver. $1. 

Weaver's Works. " Hopes and 
Helps," " Aims and Aids," "Ways of 
Life." A great work, in one vol, $3.00. 

Wedlock. Right Relations of the 
Sexes. Laws of Conjugal Selection. Who 
may and who may not Marry. For both 
Sexes. By Wells. Plain, $1.50 ; gilt, 2$. 

Capital Punishment ; or, the 

Proper Treatment of Criminals. 10 cents # 



Education of the Heart. Col- 
fax. 10 cents. Father Matthew, 

Temperance Apostle, Portrait, Charac- 
ter and Biography. 10 cents. 

or, Mary Idyl 1 3 Trials and Triumphs. By Emma 



A Self-Made Woman ; 

May Buckingham. $1.50. 
Just ready for delivery. Offers to the young and others, an agreeable story, and 
many good suggestions for living a noble, useful and happy life. 

Agents Wanted. There are many individuals in every neighbor- 
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Hundreds of Copies could be sold where they have never yet been in- 
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Address, S. It. WELLS, 389 Broadway, New York. 



